Provider Demographics
NPI:1528263761
Name:MEDLINK PHARMACY
Entity type:Organization
Organization Name:MEDLINK PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RPIC
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSOKE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:609-393-4664
Mailing Address - Street 1:850 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08611-1929
Mailing Address - Country:US
Mailing Address - Phone:609-393-4664
Mailing Address - Fax:609-393-4665
Practice Address - Street 1:850 S BROAD ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08611-1929
Practice Address - Country:US
Practice Address - Phone:609-393-4664
Practice Address - Fax:609-393-4665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRS00670600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty