Healthcare Provider Details

I. General information

NPI: 1407517618
Provider Name (Legal Business Name): JERSEY CHEMISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2022
Last Update Date: 07/12/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 ELIZABETH AVE
NEWARK NJ
07112
US

IV. Provider business mailing address

433 ELIZABETH AVE
NEWARK NJ
07112
US

V. Phone/Fax

Practice location:
  • Phone: 973-368-2925
  • Fax:
Mailing address:
  • Phone: 973-368-2925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM YANKOVICH
Title or Position: OWNER
Credential:
Phone: 917-916-8757