Healthcare Provider Details

I. General information

NPI: 1447590161
Provider Name (Legal Business Name): PUJA PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2013
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 MAIN ST
WEST ORANGE NJ
07052-5628
US

IV. Provider business mailing address

310 MAIN ST
WEST ORANGE NJ
07052-5628
US

V. Phone/Fax

Practice location:
  • Phone: 973-325-1020
  • Fax: 862-252-9450
Mailing address:
  • Phone: 973-325-1020
  • Fax: 862-252-9450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00724700
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: UMESH PATEL
Title or Position: OWNER
Credential:
Phone: 973-325-1020