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General NPI Number Information
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NPI Number | 1831232792
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Entity Type | Organization
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Legal Business Name | AMBITA CORPORATION
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 12/08/2016
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Provider Practice Location Address
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Address Line | 120 MARKET ST
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City | PASSAIC
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State | NJ
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Zip | 07055-7625
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Country | US
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Telephone | 973-473-3727
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Fax | 973-473-8003
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Provider Business Mailing Address
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Address Line | 120 MARKET ST
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City | PASSAIC
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State | NJ
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Zip | 07055-7625
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Country | US
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Telephone | 973-473-3727
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Fax | 973-473-8003
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Authorized Official
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Title or Position | VP
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Name | RAJ GANDHI
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Credential |
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Telephone | 973-473-3727
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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 |
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License Number State |
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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 | 28RS00475100
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License Number State | NJ
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