Provider Demographics
NPI:1912690009
Name:MEADOW PHARMACY AND WELLNESS LLC
Entity Type:Organization
Organization Name:MEADOW PHARMACY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMBOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-574-3040
Mailing Address - Street 1:217 BROOK AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-3300
Mailing Address - Country:US
Mailing Address - Phone:973-574-3040
Mailing Address - Fax:
Practice Address - Street 1:217 BROOK AVE STE B202
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-3357
Practice Address - Country:US
Practice Address - Phone:973-574-3040
Practice Address - Fax:973-574-3747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy