Basic Information
| Provider Information | |||||||||
| NPI: | 1083044747 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GRANDO | ||||||||
| FirstName: | DONNA | ||||||||
| MiddleName: | JEAN | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 99 ROUTE 37 W | ||||||||
| Address2: | CMC PHARMACY DEPT. | ||||||||
| City: | TOMS RIVER | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087556423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7325578000 | ||||||||
| FaxNumber: | 7325572125 | ||||||||
| Practice Location | |||||||||
| Address1: | 99 ROUTE 37 W | ||||||||
| Address2: | CMC PHARMACY DEPT. | ||||||||
| City: | TOMS RIVER | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087556423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7325578000 | ||||||||
| FaxNumber: | 7325572125 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2013 | ||||||||
| LastUpdateDate: | 11/16/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 28RI03296300 | NJ | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.