=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235048190
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | 5 CORNERS PHARMACY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/04/2026
-----------------------------------------------------
Last Update Date | 09/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 580 SUMMIT AVE
-----------------------------------------------------
City | JERSEY CITY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07306-2768
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-360-0100
-----------------------------------------------------
Fax | 201-360-0100
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 580 SUMMIT AVE
-----------------------------------------------------
City | JERSEY CITY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07306-2768
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-360-0100
-----------------------------------------------------
Fax | 201-360-0100
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JOSEPH SALIB
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 908-907-3829
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------