Provider Demographics
NPI:1003317876
Name:PLEASANT CARE PHARMACY INC
Entity Type:Organization
Organization Name:PLEASANT CARE PHARMACY INC
Other - Org Name:PLEASANT CARE PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:SIVANAND
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-415-2048
Mailing Address - Street 1:49 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08232-2745
Mailing Address - Country:US
Mailing Address - Phone:609-415-2048
Mailing Address - Fax:609-415-2057
Practice Address - Street 1:49 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08232-2745
Practice Address - Country:US
Practice Address - Phone:609-415-2048
Practice Address - Fax:609-415-2057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-26
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS007610003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2176411OtherPK