Healthcare Provider Details

I. General information

NPI: 1902738974
Provider Name (Legal Business Name): BAABA AMO-BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 E JIMMIE LEEDS RD
GALLOWAY NJ
08205-4134
US

IV. Provider business mailing address

313 E COS COB DR
GALLOWAY NJ
08205-3720
US

V. Phone/Fax

Practice location:
  • Phone: 855-927-0390
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04495900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: