Healthcare Provider Details

I. General information

NPI: 1881932093
Provider Name (Legal Business Name): H & A LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2013
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3712 PARK AVE
WEEHAWKEN NJ
07086-6033
US

IV. Provider business mailing address

3712 PARK AVE
WEEHAWKEN NJ
07086-6033
US

V. Phone/Fax

Practice location:
  • Phone: 201-552-9500
  • Fax: 201-552-9501
Mailing address:
  • Phone: 201-552-9500
  • Fax: 201-552-9501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00724100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number28RS00724100
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number28RS00724100
License Number StateNJ

VIII. Authorized Official

Name: MR. SYED M HUSSAINI
Title or Position: MANAGING AGENT
Credential: MBA
Phone: 201-552-9500