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General NPI Number Information
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NPI Number | 1245506427
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Entity Type | Organization
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Legal Business Name | THE PHARMACY AT BERGEN MEDICAL LLC
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Dates
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Enumeration Date | 04/01/2012
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 1 W RIDGEWOOD AVE STE 100
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City | PARAMUS
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State | NJ
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Zip | 07652-2359
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Country | US
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Telephone | 215-537-2701
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Fax | 215-537-2693
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Provider Business Mailing Address
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Address Line | 1 W RIDGEWOOD AVE STE 100
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City | PARAMUS
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State | NJ
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Zip | 07652-2359
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Country | US
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Telephone | 215-537-2701
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Fax | 215-537-2693
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Authorized Official
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Title or Position | PRESIDENT & OFFICER
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Name | MR. ANUSH AMIN
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Credential |
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Telephone | 973-869-2820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28RS00721500
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License Number State | NJ
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