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General NPI Number Information
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NPI Number | 1992843155
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Entity Type | Organization
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Legal Business Name | NEW LUCY'S PHARMACY INC
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 04/07/2017
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Provider Practice Location Address
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Address Line | 286 288 MONROE STREET
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City | PASSAIC
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State | NJ
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Zip | 07055
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Country | US
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Telephone | 973-778-4495
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Fax | 973-778-8843
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Provider Business Mailing Address
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Address Line | 286-288 MONROE ST UNIT B
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City | PASSAIC
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State | NJ
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Zip | 07055-5271
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Country | US
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Telephone | 973-778-4495
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Fax | 973-778-8843
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SAMIR M AWAD
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Credential |
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Telephone | 973-778-4495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28RS00681100
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License Number State | NJ
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