Provider Demographics
NPI:1487171161
Name:UNION AVENUE HEALTHCARE INC
Entity type:Organization
Organization Name:UNION AVENUE HEALTHCARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JATIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:732-356-3113
Mailing Address - Street 1:433 W UNION AVE
Mailing Address - Street 2:
Mailing Address - City:BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08805-1220
Mailing Address - Country:US
Mailing Address - Phone:732-356-3113
Mailing Address - Fax:732-356-6691
Practice Address - Street 1:433 W UNION AVE
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-1220
Practice Address - Country:US
Practice Address - Phone:732-356-3113
Practice Address - Fax:732-356-6691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy