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General NPI Number Information
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NPI Number | 1124166509
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Entity Type | Organization
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Legal Business Name | PINNACLE HEALTHCARE LLC
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 09/14/2012
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Provider Practice Location Address
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Address Line | 36 PARK AVE
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City | NEWARK
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State | NJ
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Zip | 07104-1367
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Country | US
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Telephone | 973-412-1000
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Fax | 973-412-1983
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Provider Business Mailing Address
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Address Line | 36 PARK AVE
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City | NEWARK
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State | NJ
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Zip | 07104-1367
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Country | US
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Telephone | 973-412-1000
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Fax | 973-412-1983
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Authorized Official
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Title or Position | OWNER
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Name | KAJAL VIRADIA
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Credential |
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Telephone | 201-993-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28RS00645100
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License Number State | NJ
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