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General NPI Number Information
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NPI Number | 1639212533
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Entity Type | Organization
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Legal Business Name | PATERSON DRUG INC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 430 MADISON AVE
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City | PATERSON
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State | NJ
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Zip | 07524-2728
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Country | US
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Telephone | 973-278-5808
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Fax | 973-278-3547
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Provider Business Mailing Address
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Address Line | 430 MADISON AVE
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City | PATERSON
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State | NJ
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Zip | 07524-2728
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Country | US
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Telephone | 973-278-5808
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Fax | 973-278-3547
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Authorized Official
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Title or Position | PRESIDENT, PHARMACIST
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Name | MR. CHETAN GANDHI
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Credential | RPH
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Telephone | 973-278-5808
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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 | 28RS00659700
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License Number State | NJ
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