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General NPI Number Information
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NPI Number | 1356215917
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Entity Type | Organization
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Legal Business Name | ROOTS HERBAL HEALING
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Dates
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Enumeration Date | 10/06/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 1624 13TH ST
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City | EWING
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State | NJ
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Zip | 08638-2910
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Country | US
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Telephone | 631-398-8127
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Fax | 631-398-8127
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Provider Business Mailing Address
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Address Line | 28 SPRING ST UNIT 189
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City | PRINCETON
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State | NJ
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Zip | 08542-6901
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Country | US
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Telephone | 631-398-8127
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Fax | 631-398-8127
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Authorized Official
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Title or Position | OWNER / MANAGING MEMBER
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Name | CHEVOY SMITH
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Credential | MA, MPH
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Telephone | 631-398-8127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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