Organization
YAGNAM LLC
Active
Other names
La Nueva Mercedes Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PRATIK PATEL PHARMD (PHARMACIST IN CHARGE)
(973) 279-2800
Entity
Organization
Contact information
Practice address
500 RIVER ST, PATERSON, NJ 07524-1903
(973) 279-2800
(973) 279-2197
Mailing address
500 RIVER ST, PATERSON, NJ 07524-1903
(973) 279-2800
(973) 279-2197
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00328400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2166431
PK
—
Enumeration date
11/29/2016
Last updated
04/25/2017
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