MEDICARE: PUJA PHARMACY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0004X	Compounding Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336C0003X	Community/Retail Pharmacy	28RS00724700	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3199406	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1447590161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PUJA PHARMACY LLC

Provider Business Mailing Address
First Line	:	310 MAIN ST
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-5628
Country	:	US
Telephone Number	:	973-325-1020
Fax Number	:	862-252-9450

Provider Business Practice Location Address
First Line	:	310 MAIN ST
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-5628
Country	:	US
Telephone Number	:	973-325-1020
Fax Number	:	862-252-9450

Authorized Official
Title or Position	:	OWNER
Name	:	UMESH PATEL
Credential	:
Telephone Number	:	973-325-1020

Provider Enumeration Date	:	02/15/2013
Last Update Date	:	01/26/2024

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Directions to “PUJA PHARMACY LLC ” Practice Location

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