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MEDICINE MAN RX LLC NPI 1598009383


NPI Information

NPI: 1598009383
Provider Name: MEDICINE MAN RX LLC

Doing Business As: MEDICINE MAN PHARMACY & COMPOUNDING

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 31D2194809

Address:
511 WASHINGTON ST
HOBOKEN, NJ
ZIP 07030
Phone: (201) 942-9777
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MEDICINE MAN RX LLC is a community/retail pharmacy pharmacy in Hoboken, NJ. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. MEDICINE MAN RX LLC NPI is 1598009383. The provider is registered as an organization entity type.
The provider Is Doing Business As Medicine Man Pharmacy & Compounding.

The provider's business location address is:

511 WASHINGTON ST
HOBOKEN, NJ
ZIP 07030-993
Phone: (201) 942-9777
Fax: (201) 942-9779

The provider's authorized official is Pankit Sutaria .
The authorized official title is President and has the following contact phone number (201) 942-9777.

The CLIA number assigned to this NPI record is 31D2194809 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/16/2012 and was last updated on 8/31/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail Pharmacy28RS00722900NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12153660OTHERPK
20383911MEDICAIDNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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