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General NPI Number Information
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NPI Number | 1760530968
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Entity Type | Organization
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Legal Business Name | YAMNA LLC
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Dates
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Enumeration Date | 01/07/2007
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Last Update Date | 07/23/2018
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Provider Practice Location Address
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Address Line | 1069 BERGEN ST
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City | NEWARK
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State | NJ
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Zip | 07112
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Country | US
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Telephone | 973-926-4100
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Fax | 973-926-9650
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Provider Business Mailing Address
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Address Line | 1069 BERGEN ST
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City | NEWARK
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State | NJ
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Zip | 07112-2039
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Country | US
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Telephone | 973-926-4100
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Fax | 973-926-9650
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Authorized Official
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Title or Position | OWNER
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Name | ANKUR BAROT
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Credential | PHARMACIST
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Telephone | 973-926-4100
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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 | 28RS00419200
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License Number State | NJ
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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 | 28RS00419200
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License Number State | NJ
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