Healthcare Provider Details
I. General information
NPI: 1558041020
Provider Name (Legal Business Name): PAYLESS PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/20/2023
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
222 N WOOD AVE
LINDEN NJ
07036-4220
US
IV. Provider business mailing address
222 N WOOD AVE
LINDEN NJ
07036-4220
US
V. Phone/Fax
- Phone: 908-587-2000
- Fax: 908-357-2960
- Phone: 908-587-2000
- Fax: 908-357-2960
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MOHAMMED
KHEDR
Title or Position: MANAGING MEMBER
Credential: RPH
Phone: 908-587-2000