<Unavail>

LBN: Gallos Live Well Pharmacy Inc
<Unavail> is an health care organization with primary practice located at 192 Rochelle Ave , Rochelle Park NJ 07662-4111. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Gallos Live Well Pharmacy Inc can be contacted via phone (201) 843-1350, or through Kubulak, Joseph via phone (201) 843-1350.

Contact Information

Primary practice address
192 Rochelle Ave Rochelle Park NJ 07662-4111
Phone: (201) 843-1350
Fax: (201) 843-2455
Website:
Map and Directions
Authorized official contact:
Name: Kubulak, Joseph
Phone: (201) 843-1350

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 28RS00388100 New Jersey

Profile Details

NPI number 1861599797
LBN Legal business name Gallos Live Well Pharmacy Inc
DBA Doing business as <Unavail>
Authorized official Kubulak, Joseph
Entity Organization
Organization subpart 1 No
Enumeration date Sep 20th, 2006
Last updated Nov 16th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861599797 NPPES
Other 2122854 PK
MEDICAID 0235351 PK

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