Provider Demographics
NPI:1841213261
Name:NK HEALTH SHORT HILLS LLC
Entity type:Organization
Organization Name:NK HEALTH SHORT HILLS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PRASHANT
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:973-379-3333
Mailing Address - Street 1:40 CHATHAM ROAD
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078
Mailing Address - Country:US
Mailing Address - Phone:973-379-3333
Mailing Address - Fax:973-379-4967
Practice Address - Street 1:40 CHATHAM ROAD
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078
Practice Address - Country:US
Practice Address - Phone:973-379-3333
Practice Address - Fax:973-379-4967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ7693508332B00000X
7693508332B00000X
NJ28RS005542003336C0003X
28RS005542003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7693508Medicaid
NJ7693508Medicaid