Medford Leas Pharmacy

LBN: The Estaugh
Medford Leas Pharmacy is an health care organization with primary practice located at 1 Medford Leas , Medford NJ 08055-2254. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy, Suppliers / Managed Care Organization Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. The Estaugh can be contacted via phone (609) 654-3269, or through Simmons, Frank via phone (609) 654-3391.

Contact Information

Primary practice address
1 Medford Leas Medford NJ 08055-2254
Fax: (609) 257-0827
Website:
Authorized official contact:
Name: Simmons, Frank PHARM D

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 28RS00192000 New Jersey
Suppliers / Long Term Care Pharmacy 3336L0003X
Suppliers / Managed Care Organization Pharmacy 3336M0003X

Profile Details

NPI number 1740226836
LBN Legal business name The Estaugh
DBA Doing business as Medford Leas Pharmacy
Authorized official Simmons, Frank PHARM D
Entity Organization
Organization subpart 1 No
Enumeration date Jun 20th, 2006
Last updated Jul 20th, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740226836 NPPES
Other 2056046 PK
MEDICAID 4303504 PK

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