Healthcare Provider Details

I. General information

NPI: 1639766777
Provider Name (Legal Business Name): ST JOSEPHS HEALTH PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2020
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 HAMBURG TPKE
WAYNE NJ
07470-2168
US

IV. Provider business mailing address

224 HAMBURG TPKE
WAYNE NJ
07470-2168
US

V. Phone/Fax

Practice location:
  • Phone: 973-389-5270
  • Fax: 973-389-5271
Mailing address:
  • Phone: 973-389-5270
  • Fax: 973-389-5271

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 Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RENA PATEL
Title or Position: DIRECTOR OF RETAIL AND SPECIALTY PH
Credential:
Phone: 201-458-4612