Healthcare Provider Details

I. General information

NPI: 1265292916
Provider Name (Legal Business Name): MARKET STREET RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2024
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 N STATE RT 17 STE 102
PARAMUS NJ
07652
US

IV. Provider business mailing address

142 N STATE RT 17 STE 102
PARAMUS NJ
07652
US

V. Phone/Fax

Practice location:
  • Phone: 973-955-4950
  • Fax: 973-955-4951
Mailing address:
  • Phone: 973-955-4950
  • Fax: 973-955-4951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RANA L KENANA
Title or Position: MANAGING MEMBER
Credential:
Phone: 973-955-4950