Provider Demographics
NPI:1316685332
Name:ST JOSEPH'S HEALTH PHARMACY, LLC
Entity type:Organization
Organization Name:ST JOSEPH'S HEALTH PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULATORY PHARMACY COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:RENA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-458-4612
Mailing Address - Street 1:225 MINNISINK ROAD
Mailing Address - Street 2:SUITE 1062
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512
Mailing Address - Country:US
Mailing Address - Phone:862-657-3250
Mailing Address - Fax:862-657-3255
Practice Address - Street 1:225 MINNISINK ROAD, STE 1062
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512
Practice Address - Country:US
Practice Address - Phone:862-657-3250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-20
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy