Healthcare Provider Details

I. General information

NPI: 1356134266
Provider Name (Legal Business Name): RANCH HEALTH JERSEY CITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

196 PRINCETON HIGHTSTOWN ROAD BUILDING 2 SUITE 14B
WEST WINDSOR NJ
08550
US

IV. Provider business mailing address

196 PRINCETON HIGHTSTOWN ROAD BUILDING 2 SUITE 14B
WEST WINDSOR NJ
08550
US

V. Phone/Fax

Practice location:
  • Phone: 908-325-9084
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LONG CHAO
Title or Position: PHARMACY OWNER
Credential:
Phone: 908-326-9084