1669148151 NPI number — NEW HOPE PHARMACY AND WELLNESS L.L.C

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669148151 NPI number — NEW HOPE PHARMACY AND WELLNESS L.L.C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW HOPE PHARMACY AND WELLNESS L.L.C
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669148151
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
34 BALSAM CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLLAND
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18966-2164
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-494-1442
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 VILLAGE ROW, LOGAN SQUARE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW HOPE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18938-1893
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
267-740-2950
Provider Business Practice Location Address Fax Number:
215-693-1429
Provider Enumeration Date:
08/17/2021

Additional Information

Authorized Official

Authorized Official Last Name:
AGGARWAL
Authorized Official First Name:
NITIN
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACIST
Authorized Official Telephone Number:
419-494-1442

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , registered in the state of NULL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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