Provider Demographics
NPI:1275926396
Name:CARE FAST PHARMACY LLC
Entity Type:Organization
Organization Name:CARE FAST PHARMACY LLC
Other - Org Name:CARE FAST PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:RESAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:THUNUPUNORI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-991-2569
Mailing Address - Street 1:124 SCHUYLER AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-3933
Mailing Address - Country:US
Mailing Address - Phone:201-991-2569
Mailing Address - Fax:201-991-2545
Practice Address - Street 1:124 SCHUYLER AVE
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-3933
Practice Address - Country:US
Practice Address - Phone:201-991-2569
Practice Address - Fax:201-991-2545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-13
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS007390003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2150850OtherPK