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General NPI Number Information
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NPI Number | 1215316641
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Entity Type | Organization
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Legal Business Name | PASSAIC VALLEY MEDICAL PHARMACY LLC
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Dates
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Enumeration Date | 05/19/2015
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 1225 MCBRIDE AVE SUITE 112
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City | WOODLAND PARK
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State | NJ
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Zip | 07424-3812
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Country | US
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Telephone | 973-256-0222
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Fax | 973-256-4222
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Provider Business Mailing Address
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Address Line | 1225 MCBRIDE AVE SUITE 112
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City | WOODLAND PARK
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State | NJ
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Zip | 07424-3812
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Country | US
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Telephone | 973-256-0222
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Fax | 973-256-4222
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Authorized Official
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Title or Position | PRESIDENT & OFFICER
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Name | MR. ANUSH AMIN
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Credential |
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Telephone | 973-869-2820
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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 | 28RS00740700
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License Number State | NJ
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