Healthcare Provider Details

I. General information

NPI: 1043506827
Provider Name (Legal Business Name): TESH II LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 01/27/2021
Certification Date: 01/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 BERGEN AVE
JERSEY CITY NJ
07306-4801
US

IV. Provider business mailing address

711 BERGEN AVE
JERSEY CITY NJ
07306-4801
US

V. Phone/Fax

Practice location:
  • Phone: 201-324-3900
  • Fax: 201-324-3970
Mailing address:
  • Phone: 201-324-3900
  • Fax: 201-324-3970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00712900
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier2130815
Identifier TypeOTHER
Identifier State
Identifier IssuerPK

VIII. Authorized Official

Name: MOHAMED SOLAIMAN
Title or Position: PARTNER
Credential:
Phone: 551-358-4841