Basic Information
| Provider Information | |||||||||
| NPI: | 1003148214 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | O'DONNELL | ||||||||
| FirstName: | AIMEE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1801 HWY 35 | ||||||||
| Address2: | |||||||||
| City: | WALL TOWNSHIP | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077193503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326810550 | ||||||||
| FaxNumber: | 7626815463 | ||||||||
| Practice Location | |||||||||
| Address1: | 1801 HWY 35 | ||||||||
| Address2: | |||||||||
| City: | WALL TOWNSHIP | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077193503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326810550 | ||||||||
| FaxNumber: | 7626815463 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2010 | ||||||||
| LastUpdateDate: | 02/12/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 28RI02783400 | NJ | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.