POMEGRANATE WELLNESS HEALTH AESTHETICS


Address: 203 Girard Rd N, Glassboro, NJ 08028-2117
Phone: 9737316253

POMEGRANATE WELLNESS HEALTH AESTHETICS (NPI# 1912462029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912462029
Entity Type Organization
Organization Name POMEGRANATE WELLNESS HEALTH AESTHETICS
Practice Address 203 Girard Rd N
Glassboro
NJ 08028-2117
Practice Telephone 9737316253
Mailing Telephone 9737316253
Enumeration Date 2019-02-02
Last Update Date 2019-02-02
Authorized Official Name PANSY HARRIS-LANE (OWNER)
Authorized Official Telephone 9737316253
Authorized Official Credential APN
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363L00000X Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers
Y 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities

Office Location

Street Address 203 GIRARD RD N
City GLASSBORO
State NJ
Zip Code 08028-2117

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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

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Competitor

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City GLASSBORO
Zip Code 08028

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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