=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902501265
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SCHRAFT'S 2.0
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/04/2023
-----------------------------------------------------
Last Update Date | 04/04/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3 WING DR STE 102
-----------------------------------------------------
City | CEDAR KNOLLS
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07927-1017
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 855-724-7238
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3 WING DR STE 102
-----------------------------------------------------
City | CEDAR KNOLLS
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07927-1017
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 855-724-7238
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ADAM HAIT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 908-797-3083
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336S0011X
-----------------------------------------------------
Taxonomy Name | Specialty Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------