Provider Demographics
NPI:1386741205
Name:N G H I INC
Entity type:Organization
Organization Name:N G H I INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NUNZIO
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:732-985-5110
Mailing Address - Street 1:2303 WOODBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-5599
Mailing Address - Country:US
Mailing Address - Phone:732-985-5110
Mailing Address - Fax:732-572-0985
Practice Address - Street 1:2303 WOODBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-5599
Practice Address - Country:US
Practice Address - Phone:732-985-5110
Practice Address - Fax:732-572-0985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
NJ28RS006373003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2055683OtherPK
NJ0050741Medicaid
NJ4276604Medicaid
2055683OtherPK