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General NPI Number Information
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NPI Number | 1790840130
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Entity Type | Organization
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Legal Business Name | ROSE GARDEN NUTRITION INC
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 10/15/2008
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Provider Practice Location Address
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Address Line | 22 ELIZABETH AVE SUITE 100
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City | NEWARK
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State | NJ
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Zip | 07108
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Country | US
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Telephone | 973-645-0388
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Fax | 973-624-3411
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Provider Business Mailing Address
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Address Line | P.O. 1660
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City | UNION
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State | NJ
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Zip | 07083-1660
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Country | US
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Telephone | 973-645-0388
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Fax | 973-624-3411
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Authorized Official
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Title or Position | MANAGER
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Name | AHMED F ALY
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Credential | PHARMACIST
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Telephone | 973-645-0388
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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 | 28RS00623700
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License Number State | NJ
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