Provider Demographics
NPI:1013565332
Name:NASPAC1 LLC
Entity Type:Organization
Organization Name:NASPAC1 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEULKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-410-9424
Mailing Address - Street 1:404 CREEK CROSSING BLVD # 404
Mailing Address - Street 2:
Mailing Address - City:HAINESPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08036-2768
Mailing Address - Country:US
Mailing Address - Phone:609-410-9424
Mailing Address - Fax:
Practice Address - Street 1:4101 ROUTE 42 STE C
Practice Address - Street 2:
Practice Address - City:BLACKWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08012-1782
Practice Address - Country:US
Practice Address - Phone:856-516-4566
Practice Address - Fax:856-516-4577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-29
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0002XSuppliersPharmacyClinic Pharmacy