110 VAN HOUTEN LLC
NPI: 1336665827
· PASSAIC, NJ 07055
· Community/Retail Pharmacy
· NPI assigned 08/17/2017
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | PATEL, ASHWIN (PHARMACIST) |
| NPI Enumeration Date | 08/17/2017 |
Related Entities
Other providers sharing the same authorized official: PATEL, ASHWIN
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2024 |
151 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0008 |
Administration of influenza virus vaccine |
79 |
79 |
$0.00 |
| 90653 |
|
72 |
72 |
$0.00 |