Last Updated: 12/22/2024 7:09:13 PM
Pharmacy
Detail
Corporation / Company Owner Name |
|
Business (DBA) Name |
CVS/SPECIALTY OR INGENIO RX SPECIALTY |
License Number |
99-9302 |
Type of Pharmacy |
Non-Resident |
Address |
180 PASSAIC AVE |
City, State, Zip |
FAIRFIELD,
NJ 07004 |
Country |
|
Issue Date |
08/16/2022 |
Renewed Date |
08/17/2022 |
Expiration Date |
08/31/2023 |
End Date |
02/17/2023 |
Replacing |
|
Replaced By |
|
Drug Supplier |
No |
Sterile Compounding |
No |
Training Area |
No |
Unused Drug Dispensing |
No |
LTC Emergency Kit |
No |
Pharmacist-In-Charge |
ANDREW M. GOLAS - 16252 |
Status |
CLOSED |
In Process? |
|
|
|
|
Disciplinary Action
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that column.
No Disciplinary
Action |
|
|