Healthcare Provider Details
I. General information
NPI: 1649031113
Provider Name (Legal Business Name): TIFFANY NATURAL PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/22/2024
Last Update Date: 01/22/2024
Certification Date: 01/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1115 SOUTH AVE W
WESTFIELD NJ
07090-1418
US
IV. Provider business mailing address
1115 SOUTH AVE W
WESTFIELD NJ
07090-1418
US
V. Phone/Fax
- Phone: 908-233-2200
- Fax: 908-233-3975
- Phone: 908-233-2200
- Fax: 908-233-3975
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIAN
B
PINTO
Title or Position: PHARMACIST-IN-CHARGE/OWNER
Credential: RPH
Phone: 908-233-2200