Healthcare Provider Details

I. General information

NPI: 1215853544
Provider Name (Legal Business Name): OM PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 SMITH ST
PERTH AMBOY NJ
08861-4312
US

IV. Provider business mailing address

164 SMITH ST
PERTH AMBOY NJ
08861-4312
US

V. Phone/Fax

Practice location:
  • Phone: 732-324-4200
  • Fax: 732-324-4201
Mailing address:
  • Phone: 732-324-4200
  • Fax: 732-324-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: RONAK BALAR
Title or Position: OWNER/ PHARMACIST
Credential:
Phone: 732-324-4200