Basic Information
| Provider Information | |||||||||
| NPI: | 1205023009 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | POPPE | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | RPH CCP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 136 CENTRAL AVE | ||||||||
| Address2: | PHARMACARE INC | ||||||||
| City: | CLARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7325749015 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 99 CENTRAL AVE | ||||||||
| Address2: | GREYSTONE PARK PSYCHIATRIC HOSPITAL | ||||||||
| City: | MORRIS PLAINS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07950 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9735381800 | ||||||||
| FaxNumber: | 9732854381 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2007 | ||||||||
| LastUpdateDate: | 09/26/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 28RI02037300 | NJ | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.