Healthcare Provider Details

I. General information

NPI: 1497483200
Provider Name (Legal Business Name): UNIVERSITY HEIGHTS SPECIALTY PHARMACY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198-208 W MARKET ST SUITE 216
NEWARK NJ
07103
US

IV. Provider business mailing address

198-208 W MARKET ST SUITE 216
NEWARK NJ
07103
US

V. Phone/Fax

Practice location:
  • Phone: 973-343-5850
  • Fax: 973-343-5851
Mailing address:
  • Phone: 973-343-5850
  • Fax: 973-343-5851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier0886921
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name: ZAHID BASHIR
Title or Position: OWNER
Credential:
Phone: 973-343-5850