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General NPI Number Information
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NPI Number | 1962718668
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Entity Type | Organization
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Legal Business Name | GOODMAN PHARMACY & SURGICAL INC
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Dates
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Enumeration Date | 08/19/2010
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Last Update Date | 02/18/2019
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Provider Practice Location Address
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Address Line | 296 PASSAIC ST
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City | PASSAIC
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State | NJ
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Zip | 07055-5813
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Country | US
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Telephone | 973-777-2727
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Fax | 973-777-2777
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Provider Business Mailing Address
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Address Line | 296 PASSAIC ST
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City | PASSAIC
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State | NJ
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Zip | 07055-5813
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Country | US
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Telephone | 973-777-2727
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Fax | 973-777-2777
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Authorized Official
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Title or Position | PHRMACY TECH
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Name | MRS. NIHARIKA SONI
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Credential | MGR
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Telephone | 973-777-2727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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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 |
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License Number State |
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