Healthcare Provider Details

I. General information

NPI: 1558598904
Provider Name (Legal Business Name): HEALTH CENTER PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2009
Last Update Date: 06/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 BERGENLINE AVE
WEST NEW YORK NJ
07093-1619
US

IV. Provider business mailing address

6200 BERGENLINE AVE
WEST NEW YORK NJ
07093-1619
US

V. Phone/Fax

Practice location:
  • Phone: 201-861-7521
  • Fax: 201-861-7411
Mailing address:
  • Phone: 201-861-7521
  • Fax: 201-861-7411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00689600
License Number StateNJ

VIII. Authorized Official

Name: HEMIL KHANDWALA
Title or Position: PRESIDENT
Credential:
Phone: 201-861-7521