Provider Demographics
NPI:1053802819
Name:FERRY PHARMACY
Entity type:Organization
Organization Name:FERRY PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:BELAL
Authorized Official - Middle Name:
Authorized Official - Last Name:DALIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:551-482-4022
Mailing Address - Street 1:165 FERRY ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-2179
Mailing Address - Country:US
Mailing Address - Phone:973-344-0394
Mailing Address - Fax:973-344-0395
Practice Address - Street 1:165 FERRY ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105
Practice Address - Country:US
Practice Address - Phone:973-344-0394
Practice Address - Fax:973-344-0395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-28
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS007637003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2177762OtherPK