Provider Demographics
NPI:1497357149
Name:NEWARK NEW PHARMACY LLC
Entity Type:Organization
Organization Name:NEWARK NEW PHARMACY LLC
Other - Org Name:NEWARK RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:METRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HABASHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-388-4667
Mailing Address - Street 1:13 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102
Mailing Address - Country:US
Mailing Address - Phone:973-500-3660
Mailing Address - Fax:973-500-3666
Practice Address - Street 1:13 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102
Practice Address - Country:US
Practice Address - Phone:973-500-3660
Practice Address - Fax:973-500-3666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-09
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RS00780900OtherBOARD OF PHARMACY