MEDICARE: AMRITA HEALTHCARE, 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	333600000X	Pharmacy

General Provider Information

NPI Number	:	1982034369
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMRITA HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	236 S ORANGE AVE
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07103-2459
Country	:	US
Telephone Number	:	973-732-9762
Fax Number	:	973-877-4763

Provider Business Practice Location Address
First Line	:	236 S ORANGE AVE
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07103-2459
Country	:	US
Telephone Number	:	973-732-9762
Fax Number	:	973-877-4763

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	DR. SHVETA HOLANI-PATEL
Credential	:	PHARMD
Telephone Number	:	973-732-9762

Provider Enumeration Date	:	11/20/2013
Last Update Date	:	08/19/2016

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