LIGHT PHARMACY LLC (LIGHT PHARMACY) - NPI NUMBER 1336485283

Summary

Provider Name: LIGHT PHARMACY LLC (LIGHT PHARMACY)

NPI Number: 1336485283

Clasification: Pharmacy (3336C0003X)

Specialization: Community/Retail Pharmacy

Address:
212 LAUREL HEIGHTS DR
BRIDGETON, NJ
ZIP 08302

Phone Number: (856) 417-0005



Detailed Information

LIGHT PHARMACY LLC is a community/retail pharmacy pharmacy in Bridgeton, NJ. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. The assigned NPI number for this provider is 1336485283 and is registered as an organization entity type.
The provider Is Doing Business As Light Pharmacy.

The provider's business address is:

212 LAUREL HEIGHTS DR
BRIDGETON, NJ
ZIP 08302-634
Phone: (856) 417-0005

The provider's authorized official is Aaron King .
The authorized official title is Owner/pic and has the following contact phone number (856) 417-0005.

The enumeration date for this NPI number is 12/21/2012 and was last updated on 12/21/2012.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 3336C0003X Pharmacy Community/Retail Pharmacy 28RS00721200 NJ No
2 3336C0004X Pharmacy Compounding Pharmacy 28RS00721200 NJ Yes

NPI Record

No. Field Name Field Value
1 NPI 1336485283
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name LIGHT PHARMACY LLC
5 Provider Other Organization Name LIGHT PHARMACY
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 212 LAUREL HEIGHTS DR
8 Provider Business Practice Location Address City Name BRIDGETON
9 Provider Business Practice Location Address State Name NJ
10 Provider Business Practice Location Address Postal Code 083023634
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 8564170005
13 Provider Enumeration Date 12/21/2012
14 Last Update Date 12/21/2012
15 Authorized Official Last Name KING
16 Authorized Official First Name AARON
17 Authorized Official Title or Position OWNER/PIC
18 Authorized Official Telephone Number 8564170005
19 Healthcare Provider Taxonomy Code 1 3336C0003X
20 Provider License Number 1 28RS00721200
21 Provider License Number State Code 1 NJ
22 Healthcare Provider Primary Taxonomy Switch 1 N
23 Healthcare Provider Taxonomy Code 2 3336C0004X
24 Provider License Number 2 28RS00721200
25 Provider License Number State Code 2 NJ
26 Healthcare Provider Primary Taxonomy Switch 2 Y
27 Is Organization Subpart N
28 Authorized Official Name Prefix Text MR.
29 Authorized Official Credential Text RPH

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This page was last updated on: 9/11/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.