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General NPI Number Information
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NPI Number | 1770810574
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Entity Type | Organization
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Legal Business Name | FENNY I PHARMACY LLC
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Dates
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Enumeration Date | 11/16/2009
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Last Update Date | 03/03/2016
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Provider Practice Location Address
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Address Line | 362 MONROE ST # C
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City | PASSAIC
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State | NJ
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Zip | 07055-4114
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Country | US
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Telephone | 973-928-2230
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Fax | 973-928-2269
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Provider Business Mailing Address
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Address Line | 1 COMMANDERS CT
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City | TOTOWA
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State | NJ
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Zip | 07512-2197
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Country | US
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Telephone | 646-417-3844
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Fax | 973-371-2247
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Authorized Official
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Title or Position | PRESIDENT
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Name | PARESH GANDHI
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Credential | B.PHARM
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Telephone | 646-417-3844
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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 | 28RS00698900
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License Number State | NJ
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