Provider Demographics
NPI:1639285042
Name:MARS HEALTHCARE INC
Entity type:Organization
Organization Name:MARS HEALTHCARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:NILAY
Authorized Official - Middle Name:
Authorized Official - Last Name:THAKKAR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:908-276-0062
Mailing Address - Street 1:17 N UNION AVE # 1
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-5101
Mailing Address - Country:US
Mailing Address - Phone:908-276-0062
Mailing Address - Fax:908-276-9450
Practice Address - Street 1:17 N UNION AVE
Practice Address - Street 2:#1
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-5101
Practice Address - Country:US
Practice Address - Phone:908-276-0062
Practice Address - Fax:908-276-9450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28R500355900333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0561886Medicaid
3104267OtherNABP
NJ4356501Medicaid