Provider Demographics
NPI:1508196692
Name:ME AND HIM
Entity Type:Organization
Organization Name:ME AND HIM
Other - Org Name:HIAWATHA PHARMACY DEPT.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:ATTA
Authorized Official - Middle Name:
Authorized Official - Last Name:REHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:862-600-7856
Mailing Address - Street 1:435 N BEVERWYCK RD
Mailing Address - Street 2:
Mailing Address - City:LAKE HIAWATHA
Mailing Address - State:NJ
Mailing Address - Zip Code:07034-2510
Mailing Address - Country:US
Mailing Address - Phone:973-794-4909
Mailing Address - Fax:973-794-4910
Practice Address - Street 1:435 N BEVERWYCK RD
Practice Address - Street 2:
Practice Address - City:LAKE HIAWATHA
Practice Address - State:NJ
Practice Address - Zip Code:07034-2510
Practice Address - Country:US
Practice Address - Phone:973-794-4909
Practice Address - Fax:973-794-4910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-12
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS007009003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3196727OtherNCPDP PROVIDER IDENTIFICATION NUMBER