Provider Demographics
NPI:1851182695
Name:COMMUNIPAW PHARMACY LLC
Entity type:Organization
Organization Name:COMMUNIPAW PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:REDA
Authorized Official - Last Name:GAWRGUS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:201-893-0307
Mailing Address - Street 1:521 BERGEN AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-2506
Mailing Address - Country:US
Mailing Address - Phone:201-721-5475
Mailing Address - Fax:201-721-5493
Practice Address - Street 1:521 BERGEN AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-2506
Practice Address - Country:US
Practice Address - Phone:201-721-5475
Practice Address - Fax:201-721-5493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-13
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy