# MEDICINE MAN RX LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Medicine Man Pharmacy & Compounding
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598009383
- **Authorized official:** PANKIT SUTARIA (PRESIDENT)
- **Authorized official phone:** (201) 942-9777

## Contact information

- **Practice address:** 511 WASHINGTON ST, HOBOKEN, NJ 07030-4993
- **Practice address phone:** (201) 942-9777
- **Practice address fax:** (201) 942-9779
- **Mailing address:** 511 WASHINGTON ST, HOBOKEN, NJ 07030-4993
- **Mailing address phone:** (201) 942-9777
- **Mailing address fax:** (201) 942-9779

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 28RS00722900 | NJ | Yes |

## Other

- **Enumeration date:** 11/16/2012
- **Last updated:** 10/02/2024