Provider Demographics
NPI:1447590161
Name:PUJA PHARMACY LLC
Entity Type:Organization
Organization Name:PUJA PHARMACY LLC
Other - Org Name:WEST ORANGE FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:UMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-325-1020
Mailing Address - Street 1:310 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-5628
Mailing Address - Country:US
Mailing Address - Phone:973-325-1020
Mailing Address - Fax:862-252-9450
Practice Address - Street 1:310 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-5628
Practice Address - Country:US
Practice Address - Phone:973-325-1020
Practice Address - Fax:862-252-9450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-15
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X
NJ28RS007247003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3199406OtherNCPDP PROVIDER IDENTIFICATION NUMBER
3199406OtherNCPDP PROVIDER IDENTIFICATION NUMBER