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NPI 1629094255

NPI 1629094255 : PB PHARMACY : PATERSON, NJ

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General NPI Number Information
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    NPI Number           |    1629094255
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    Entity Type          |    Organization 
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    Legal Business Name  |    PB PHARMACY 
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Dates
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    Enumeration Date     |    07/15/2006
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    Last Update Date     |    03/11/2020
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Provider Practice Location Address
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    Address Line         |    222 UNION AVENUE 
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    City                 |    PATERSON
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    State                |    NJ
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    Zip                  |    07502
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    Country              |    US
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    Telephone            |    973-942-7329
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    Fax                  |    973-942-4647
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Provider Business Mailing Address
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    Address Line         |    222 UNION AVENUE 
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    City                 |    PATERSON
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    State                |    NJ
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    Zip                  |    07502
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    Country              |    US
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    Telephone            |    973-942-7329
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    Fax                  |    973-942-4647
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MR. AMIT  PATEL 
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    Credential           |    
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    Telephone            |    732-688-6160
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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       |    28RS00395700
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    License Number State |    NJ
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