Provider Demographics
NPI:1992442768
Name:SOUTH BRUNSWICK PHARMACY INC
Entity type:Organization
Organization Name:SOUTH BRUNSWICK PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AQEEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-997-7707
Mailing Address - Street 1:485 GEORGES RD STE 110
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08810-1436
Mailing Address - Country:US
Mailing Address - Phone:732-997-7707
Mailing Address - Fax:732-823-1112
Practice Address - Street 1:485 GEORGES RD STE 110
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:NJ
Practice Address - Zip Code:08810-1436
Practice Address - Country:US
Practice Address - Phone:732-997-7707
Practice Address - Fax:732-823-1112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy