Healthcare Provider Details

I. General information

NPI: 1831178581
Provider Name (Legal Business Name): HEALTH CENTER PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 08/22/2020
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:
Mailing address:
  • Phone: 201-861-7521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number28RS00594200
License Number StateNJ

VIII. Authorized Official

Name: MR. RENE DEHOMBRE
Title or Position: RP IN CHARGE
Credential: R.P.
Phone: 201-861-7521