Provider Demographics
NPI:1699231431
Name:LSC PHARMACY SERVICES, INC.
Entity type:Organization
Organization Name:LSC PHARMACY SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:GRIFFITH
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:908-565-4678
Mailing Address - Street 1:94 OLD SHORT HILLS RD - EAST WING - GRVL
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039
Mailing Address - Country:US
Mailing Address - Phone:973-322-2946
Mailing Address - Fax:973-322-2419
Practice Address - Street 1:1825 JOHN F KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-2106
Practice Address - Country:US
Practice Address - Phone:201-885-4732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIVINGSTON SERVICES CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-18
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RS00770600OtherNJBOP