Organization
200 CHESTNUT ST LLC
Active
Other names
ROSELLE PARK RITA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SANJAY SHAH RPH (PHARMACIST IN CHARGE)
(908) 245-1396
Entity
Organization
Contact information
Practice address
200 CHESTNUT ST, ROSELLE PARK, NJ 07204-2263
(908) 245-1396
(908) 245-1616
Mailing address
200 CHESTNUT ST, ROSELLE PARK, NJ 07204-2263
(908) 245-1396
(908) 245-1616
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00660900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0102831
—
NJ
01
—
2054615
PK
—
Enumeration date
06/19/2006
Last updated
02/16/2017
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