Healthcare Provider Details

I. General information

NPI: 1972863587
Provider Name (Legal Business Name): TAKE CARE PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2012
Last Update Date: 01/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

182A ELMORA AVE
ELIZABETH NJ
07202-2114
US

IV. Provider business mailing address

182A ELMORA AVE
ELIZABETH NJ
07202-2114
US

V. Phone/Fax

Practice location:
  • Phone: 908-351-5768
  • Fax:
Mailing address:
  • Phone: 908-351-5768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number28RS00719000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00719000
License Number StateNJ

VIII. Authorized Official

Name: DR. SABINA SEBASTIAN
Title or Position: OWNER
Credential: PHARM. D
Phone: 908-351-5768