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General NPI Number Information
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NPI Number | 1821897380
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Entity Type | Organization
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Legal Business Name | PASSAIC PHARMACY AND MEDICAL SUPPLIES LLC
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 156 PASSAIC ST
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City | PASSAIC
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State | NJ
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Zip | 07055-7392
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Country | US
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Telephone | 908-382-0158
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Fax | 908-382-0156
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Provider Business Mailing Address
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Address Line | 156 PASSAIC ST
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City | PASSAIC
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State | NJ
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Zip | 07055-7392
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Country | US
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Telephone | 908-382-0158
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Fax | 908-382-0156
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Authorized Official
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Title or Position | OWNER/PHARMACIST IN CHARGE
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Name | DR. LOBNA OMAR
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Credential |
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Telephone | 347-259-0115
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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 |
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License Number State |
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