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General NPI Number Information
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NPI Number | 1003309428
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Entity Type | Organization
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Legal Business Name | HOLY NAME MEDICAL CENTER INC
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 718 TEANECK RD STE 2
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City | TEANECK
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State | NJ
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Zip | 07666
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Country | US
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Telephone | 201-530-7991
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Fax | 201-530-7992
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Provider Business Mailing Address
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Address Line | 718 TEANECK RD STE 2
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City | TEANECK
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State | NJ
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Zip | 07666-4245
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Country | US
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Telephone | 201-530-7991
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Fax | 201-530-7992
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Authorized Official
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Title or Position | BOARD OFFICER
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Name | DOUG ZEHNER
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Credential |
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Telephone | 201-833-7016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28RS00762300
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License Number State | NJ
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