Blooming Health LLC
Organization Active NPI Community/Retail Pharmacy · Park Ridge, NJ
NPI 1194367987 · NPPES record last updated May 16, 2025
Key facts
- NPI
- 1194367987
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- BLOOMING HEALTH LLC
- Practice address
- 40 Park Ave
Park Ridge, NJ 07656-1454 - Phone
- (201) 554-2200
- Fax
- (201) 554-2300
- NPI assigned
- Oct 13, 2019
- Organization subpart
- No
Authorized official
- Name
- Amgad Wassef
- Title
- Ceo / Owner
- Phone
- (914) 886-2253
Practitioners 5
-
Amgad Wassef, RPH, MBA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200602002571 | NJ | Part B Supplier - Pharmacy | 1254752009 | Practice locations: Park Ridge, NJ |
| O20200622002024 | NJ | DME Supplier - Pharmacy | 1254752009 | Practice locations: Park Ridge, NJ |
| O20210325001566 | NJ | Part B Supplier - Independent Clinical Laboratory | 1254752009 | Practice locations: Park Ridge, NJ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
40 Park Ave
Park Ridge, NJ 07656-1454
Mailing address
40 Park Ave
Park Ridge, NJ 07656-1454
Phone (914) 886-2253
Other names
- Park Ridge Pharmacy
Other providers in Park Ridge, NJ
- Brianna Lyn Barone
- Arthur Scot Barthold
- Jorge Becerra
- Ava Luciana Berenato
- Blooming Health LLC
- Stephanie Blum
- Keri Bratcher
- Evalynne Velez Braun
- Joseph Adams Braun
- Nancy Broderick
All providers in Park Ridge, NJ · Community/Retail Pharmacy in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.