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General NPI Number Information
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NPI Number | 1912690009
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Entity Type | Organization
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Legal Business Name | MEADOW PHARMACY AND WELLNESS LLC
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Dates
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Enumeration Date | 06/02/2023
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Last Update Date | 06/02/2023
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Provider Practice Location Address
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Address Line | 217 BROOK AVE STE B202
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City | PASSAIC
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State | NJ
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Zip | 07055-3357
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Country | US
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Telephone | 973-574-3040
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Fax | 973-574-3747
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Provider Business Mailing Address
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Address Line | 217 BROOK AVE STE 1
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City | PASSAIC
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State | NJ
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Zip | 07055-3300
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Country | US
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Telephone | 973-574-3040
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MOSHE TAMBOR
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Credential |
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Telephone | 973-574-3040
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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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