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Contact Information

THE ESTAUGH
1 MEDFORD LEAS
MEDFORD, NJ08055-2254
 Phone: 609-654-3269
 Fax: 609-257-0827
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Managed Care Organization Pharmacy

3336M0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for THE ESTAUGH

NPI Number 1740226836
LBN Legal business name THE ESTAUGH
Authorized official FRANK SIMMONS - (PHCY DIR)
Entity Organization
Organization subpart 1 No
Enumeration date 06/20/2006
Last updated 07/20/2016 - About 10 years ago
Identifiers
NJ License # 28RS00192000
NJ Medicaid 4303504
Other 2056046 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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