Provider Demographics
NPI:1336429778
Name:BRIARWOOD PHARMACY INC
Entity type:Organization
Organization Name:BRIARWOOD PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:HARSHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-610-7296
Mailing Address - Street 1:2450 KUSER RD STE G
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3359
Mailing Address - Country:US
Mailing Address - Phone:609-587-2838
Mailing Address - Fax:609-587-1811
Practice Address - Street 1:2450 KUSER RD STE G
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3359
Practice Address - Country:US
Practice Address - Phone:609-587-2838
Practice Address - Fax:609-587-1811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-17
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS007139003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3198050OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NJ6607520001Medicare NSC