Healthcare Provider Details

I. General information

NPI: 1396452579
Provider Name (Legal Business Name): SARAH S PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2022
Last Update Date: 12/01/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HIGHWOOD AVE
TENAFLY NJ
07670-1850
US

IV. Provider business mailing address

8611 4TH AVE
NORTH BERGEN NJ
07047-5133
US

V. Phone/Fax

Practice location:
  • Phone: 201-310-6779
  • Fax:
Mailing address:
  • Phone: 201-310-6779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. NASSER AYOUB
Title or Position: OWNER
Credential:
Phone: 201-310-6779