Provider Demographics
NPI:1336613017
Name:AMITVRAJ LLC
Entity Type:Organization
Organization Name:AMITVRAJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-207-3527
Mailing Address - Street 1:601 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-5906
Mailing Address - Country:US
Mailing Address - Phone:732-222-5400
Mailing Address - Fax:
Practice Address - Street 1:601 BROADWAY
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-5906
Practice Address - Country:US
Practice Address - Phone:732-222-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy