Healthcare Provider Details

I. General information

NPI: 1689655359
Provider Name (Legal Business Name): TOWN TOTAL NUTRITION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 07/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 E 32ND ST FL 5
NEW YORK NY
10016-5422
US

IV. Provider business mailing address

6 E 32ND ST FL 5
NEW YORK NY
10016-5422
US

V. Phone/Fax

Practice location:
  • Phone: 212-213-5570
  • Fax: 212-213-5616
Mailing address:
  • Phone: 212-213-5570
  • Fax: 212-213-5616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number021133
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOHN NAVARRA
Title or Position: CEO/PRESIDENT
Credential: RPH
Phone: 212-213-5570