Larry Myerson
Individual provider Active NPI Pharmacist · Pitman, NJ
NPI 1164549945 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1164549945
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 28RI01311300 (NJ)
- Practice address
- 39 S Broadway
Pitman, NJ 08071-1413 - Phone
- (856) 589-2392
- NPI assigned
- Mar 25, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI01311300 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pitman Pharmacy Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI01311300 | NJ | Yes |
Addresses
Primary practice location
39 S Broadway
Pitman, NJ 08071-1413
Mailing address
1811 Redwood Dr
Vineland, NJ 08361-6769
Other providers in Pitman, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.