Provider Demographics
NPI:1326467275
Name:VEDNORZA
Entity Type:Organization
Organization Name:VEDNORZA
Other - Org Name:RED APPLE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDULRAHMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALJETAWI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-400-7075
Mailing Address - Street 1:1135 MAIN AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2353
Mailing Address - Country:US
Mailing Address - Phone:862-400-7075
Mailing Address - Fax:973-773-7001
Practice Address - Street 1:1135 MAIN AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2353
Practice Address - Country:US
Practice Address - Phone:862-400-7075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-08
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy