Provider Demographics
NPI:1548953029
Name:WELLNESS SUPERMARKET & PHARMACY
Entity type:Organization
Organization Name:WELLNESS SUPERMARKET & PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TUHINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-900-6985
Mailing Address - Street 1:701 FRANK E RODGERS BLVD N
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07029-2627
Mailing Address - Country:US
Mailing Address - Phone:973-900-6985
Mailing Address - Fax:
Practice Address - Street 1:701 FRANK E RODGERS BLVD N STE 2
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NJ
Practice Address - Zip Code:07029-2627
Practice Address - Country:US
Practice Address - Phone:973-900-6985
Practice Address - Fax:973-900-6986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-31
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies