Provider Demographics
NPI:1508878992
Name:TIFFANY NATURAL PHARMACY INC.
Entity Type:Organization
Organization Name:TIFFANY NATURAL PHARMACY INC.
Other - Org Name:TIFFANY NATURAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:PINTO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:908-233-6985
Mailing Address - Street 1:1115 SOUTH AVE W
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-1418
Mailing Address - Country:US
Mailing Address - Phone:908-233-2200
Mailing Address - Fax:908-233-3975
Practice Address - Street 1:1115 SOUTH AVE W
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-1418
Practice Address - Country:US
Practice Address - Phone:908-233-2200
Practice Address - Fax:908-233-3975
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TIFFANY NATURAL PHARMACY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-13
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS0057530000332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3141479OtherNABP #
NJ8059811OtherMEDICAID DME
NJ8059802Medicaid
NJ3141479OtherNABP #