Healthcare Provider Details

I. General information

NPI: 1689294209
Provider Name (Legal Business Name): CLEARMD PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2020
Last Update Date: 04/23/2020
Certification Date: 04/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 E WILLOW ST
MILLBURN NJ
07041-1416
US

IV. Provider business mailing address

61 E WILLOW ST
MILLBURN NJ
07041-1416
US

V. Phone/Fax

Practice location:
  • Phone: 888-717-7654
  • Fax:
Mailing address:
  • Phone: 888-717-7654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ZE JIANG
Title or Position: PRESIDENT & CEO
Credential: PHARMD, MBA, BCSCP
Phone: 267-319-2183