Organization
GOOD LIFE PHARMACY AND WELLNESS
Active
Other names
Good Life Pharmacy & wellness center
Organization subpart
No
Provider details
NPI number
Authorized official
MIRVAT KADDOUR (OWNER)
(973) 782-6868
Entity
Organization
Contact information
Practice address
953 MAIN ST, PATERSON, NJ 07503-2350
(973) 782-6868
(973) 782-6870
Mailing address
7900 KENNEDY BLVD, NORTH BERGEN, NJ 07047-4120
(201) 654-1862
(201) 751-4191
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00714700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0293041
—
NJ
01
—
2131930
PK
—
Enumeration date
03/28/2011
Last updated
12/30/2013
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