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Organization

BLOOMING PHARMACY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HANY MIKHAIL (PHARMACIST IN CHARGE)
(973) 742-0054
Entity
Organization

Contact information

Practice address
102 BROADWAY, PATERSON, NJ 07505-1107
(973) 742-0054
(973) 742-0074
Mailing address
102 BROADWAY, PATERSON, NJ 07505-1107
(973) 742-0054
(973) 742-0074

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
28RS00764600
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2177997
PK
Enumeration date
06/04/2018
Last updated
04/09/2019
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