Organization
GRAND STREET PHARMACY LLC
Active
Other names
Grand Street Pharmacy, Nikky's Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAMESH GAJJAR (OWENER)
(973) 898-9800
Entity
Organization
Contact information
Practice address
351 GRAND ST, PATERSON, NJ 07505-2034
(973) 374-6480
(973) 374-6730
Mailing address
351 GRAND ST, PATERSON, NJ 07505-2034
(973) 898-9800
(973) 379-9067
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
28RS00751800
NJ
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2165963
PK
—
Enumeration date
06/26/2016
Last updated
04/04/2022
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