Provider Demographics
NPI:1508192360
Name:HARI PHARMACUTICAL LLC
Entity Type:Organization
Organization Name:HARI PHARMACUTICAL LLC
Other - Org Name:SUPREMO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MANU
Authorized Official - Middle Name:
Authorized Official - Last Name:JETLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-723-6301
Mailing Address - Street 1:19 AMELIA ST
Mailing Address - Street 2:
Mailing Address - City:N CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-4155
Mailing Address - Country:US
Mailing Address - Phone:973-723-6301
Mailing Address - Fax:
Practice Address - Street 1:323 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-1714
Practice Address - Country:US
Practice Address - Phone:201-876-9921
Practice Address - Fax:201-876-9926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy