Provider Demographics
NPI:1790423655
Name:WAJEJO LLC
Entity Type:Organization
Organization Name:WAJEJO LLC
Other - Org Name:RICHLAND HEALTH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:NIEDZWIKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-217-6976
Mailing Address - Street 1:719 S WEST END BLVD
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-2613
Mailing Address - Country:US
Mailing Address - Phone:445-448-0857
Mailing Address - Fax:267-217-6980
Practice Address - Street 1:719 S WEST END BLVD
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-2613
Practice Address - Country:US
Practice Address - Phone:445-448-0857
Practice Address - Fax:267-217-6980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-21
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy