Healthcare Provider Details

I. General information

NPI: 1174439665
Provider Name (Legal Business Name): LUNACARE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 SMITH ST
PERTH AMBOY NJ
08861-4043
US

IV. Provider business mailing address

311 SMITH ST
PERTH AMBOY NJ
08861-4043
US

V. Phone/Fax

Practice location:
  • Phone: 732-589-0350
  • Fax: 732-807-6255
Mailing address:
  • Phone: 732-589-0350
  • Fax: 732-807-6255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MOHAMMAD A HASHIM
Title or Position: OWNER
Credential:
Phone: 732-589-0350