Organization
KHAWAJARX
Active
Other names
WellCare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
HASHAM KHAWAJA (PRESIDENT/PIC)
(973) 953-1540
Entity
Organization
Contact information
Practice address
3406 BERGENLINE AVE, UNION CITY, NJ 07087-3922
(201) 590-9040
(201) 590-9041
Mailing address
3406 BERGENLINE AVE, UNION CITY, NJ 07087-3922
(201) 590-9040
(201) 590-9041
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
28RS00717200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2133154
PK
—
Enumeration date
10/24/2011
Last updated
11/29/2016
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