Healthcare Provider Details

I. General information

NPI: 1205978376
Provider Name (Legal Business Name): FEEHA MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 10/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 BROAD AVE
RIDGEFIELD NJ
07657-2346
US

IV. Provider business mailing address

321 BROAD AVE
RIDGEFIELD NJ
07657-2346
US

V. Phone/Fax

Practice location:
  • Phone: 201-943-8787
  • Fax: 201-943-7898
Mailing address:
  • Phone: 201-943-8787
  • Fax: 201-943-7898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number28RS00577500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHAE HA
Title or Position: PHARMACIST-IN-CHARGE
Credential:
Phone: 201-943-8787