# BLUE GOOSE PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821769704
- **Authorized official:** IRFAN NASIM (OWNER)
- **Authorized official phone:** (551) 333-4434

## Contact information

- **Practice address:** 2106 KENNEDY BLVD \# 2, UNION CITY, NJ 07087-2144
- **Practice address phone:** (201) 864-1924
- **Mailing address:** 2106 KENNEDY BLVD \# 2, UNION CITY, NJ 07087-2144
- **Mailing address phone:** (201) 864-1924

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 09/21/2021
- **Last updated:** 11/23/2021