Organization
LONDON PRIVATE LLC
Active
Other names
SUN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TANUP PATEL PHARM D. (OWNER, PIC)
(908) 331-3426
Entity
Organization
Contact information
Practice address
989 BLOOMFIELD AVE, GLEN RIDGE, NJ 07028-1301
(973) 429-9300
(973) 429-9302
Mailing address
989 BLOOMFIELD AVE, GLEN RIDGE, NJ 07028-1301
(973) 429-9300
(973) 429-9302
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00738200
NJ
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0471437
—
NJ
01
—
2149700
PK
—
Enumeration date
01/13/2015
Last updated
07/07/2016
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