Provider Demographics
NPI:1053636043
Name:RHN 6200, INC.
Entity Type:Organization
Organization Name:RHN 6200, INC.
Other - Org Name:HEALTH CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEHOMBRE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:201-861-7521
Mailing Address - Street 1:6200 BERGENLINE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-1619
Mailing Address - Country:US
Mailing Address - Phone:201-861-7521
Mailing Address - Fax:201-861-1471
Practice Address - Street 1:6200 BERGENLINE AVE
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-1619
Practice Address - Country:US
Practice Address - Phone:201-861-7521
Practice Address - Fax:201-861-1471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-01
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS007017003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6393610001Medicare NSC