Healthcare Provider Details

I. General information

NPI: 1023038478
Provider Name (Legal Business Name): MARUTI DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 06/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 BOULEVARD
KENILWORTH NJ
07033-1637
US

IV. Provider business mailing address

501 BOULEVARD
KENILWORTH NJ
07033-1637
US

V. Phone/Fax

Practice location:
  • Phone: 908-276-8540
  • Fax: 908-276-9655
Mailing address:
  • Phone: 908-276-8540
  • Fax: 908-276-9655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number28RS00584000
License Number StateNJ

VIII. Authorized Official

Name: MR. SANJAY P SHAH
Title or Position: PRESIDENT
Credential: RPH
Phone: 908-276-8540