Healthcare Provider Details

I. General information

NPI: 1992637995
Provider Name (Legal Business Name): BERGENLINE MEDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 BERGENLINE AVE
UNION CITY NJ
07087-3523
US

IV. Provider business mailing address

2301 BERGENLINE AVE
UNION CITY NJ
07087-3523
US

V. Phone/Fax

Practice location:
  • Phone: 201-348-2667
  • Fax: 201-348-0436
Mailing address:
  • Phone:
  • Fax:

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: KHALIDA NABILA
Title or Position: MEMBER
Credential:
Phone: 201-348-2667