Healthcare Provider Details

I. General information

NPI: 1700557816
Provider Name (Legal Business Name): PARKVIEW PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2021
Last Update Date: 04/05/2022
Certification Date: 04/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 QUEEN ANNE RD
TEANECK NJ
07666-3518
US

IV. Provider business mailing address

19 PARSELLS CT
CLOSTER NJ
07624-2915
US

V. Phone/Fax

Practice location:
  • Phone: 201-837-6368
  • Fax:
Mailing address:
  • Phone: 917-547-9223
  • Fax:

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:

VIII. Authorized Official

Name: MRS. PARDIS POURNAZARI
Title or Position: PHARMACIST
Credential: PHARMD
Phone: 917-547-9223