Healthcare Provider Details

I. General information

NPI: 1053456707
Provider Name (Legal Business Name): HARTFORD UNIVERSAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 07/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 COLLINGS AVE
WEST COLLINGSWOOD NJ
08107-1725
US

IV. Provider business mailing address

701 COLLINGS AVE
WEST COLLINGSWOOD NJ
08107-1725
US

V. Phone/Fax

Practice location:
  • Phone: 856-854-2022
  • Fax: 856-858-2898
Mailing address:
  • Phone: 856-854-2022
  • Fax: 856-858-2898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00602000
License Number StateNJ

VIII. Authorized Official

Name: MR. RAMASWAMY C GUMMADI
Title or Position: PHARMACIST
Credential: RPH
Phone: 856-854-2022