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General NPI Number Information
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NPI Number | 1972883734
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Entity Type | Organization
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Legal Business Name | ST GEORGE HEALTHCARE
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Dates
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Enumeration Date | 08/25/2011
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Last Update Date | 02/23/2022
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Provider Practice Location Address
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Address Line | 332 W SAINT GEORGES AVE
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City | LINDEN
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State | NJ
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Zip | 07036-5638
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Country | US
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Telephone | 908-925-4567
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Fax | 908-925-8090
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Provider Business Mailing Address
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Address Line | 332 W SAINT GEORGES AVE
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City | LINDEN
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State | NJ
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Zip | 07036-5638
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Country | US
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Telephone | 908-925-4567
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | VINEET PARIKH
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Credential | PHARMD
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Telephone | 908-925-4567
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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 | 28RS00714300
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License Number State | NJ
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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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