# AQUAVITA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AquaVita
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821488651
- **Authorized official:** FADY BISHAI (OWNER)
- **Authorized official phone:** (732) 801-3235

## Contact information

- **Practice address:** 630 TOWNE CENTRE DR, NORTH BRUNSWICK, NJ 08902-1236
- **Practice address phone:** (732) 658-3771
- **Practice address fax:** (888) 225-2388
- **Mailing address:** 630 TOWNE CENTRE DR, NORTH BRUNSWICK, NJ 08902-1236
- **Mailing address phone:** (732) 658-3771
- **Mailing address fax:** (888) 225-2388

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 28RS00737700 | NJ | Yes |

## Other

- **Enumeration date:** 02/02/2015
- **Last updated:** 02/02/2015