Provider Demographics
NPI:1245853621
Name:NATES NJ PHARMACY CORP
Entity type:Organization
Organization Name:NATES NJ PHARMACY CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:VENKATA
Authorized Official - Middle Name:PHANI
Authorized Official - Last Name:APASANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-787-1314
Mailing Address - Street 1:199 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KEANSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:07734-1768
Mailing Address - Country:US
Mailing Address - Phone:732-787-1314
Mailing Address - Fax:732-495-5590
Practice Address - Street 1:199 MAIN ST
Practice Address - Street 2:
Practice Address - City:KEANSBURG
Practice Address - State:NJ
Practice Address - Zip Code:07734-1768
Practice Address - Country:US
Practice Address - Phone:732-787-1314
Practice Address - Fax:732-495-5590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-20
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy