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General NPI Number Information
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NPI Number | 1467652057
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Entity Type | Organization
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Legal Business Name | JERUSALEM PHARMACY
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Dates
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Enumeration Date | 07/20/2007
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 1414 MAIN AVE
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City | CLIFTON
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State | NJ
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Zip | 07011-2157
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Country | US
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Telephone | 973-340-6200
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Fax | 973-340-6204
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Provider Business Mailing Address
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Address Line | 1414 MAIN AVE
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City | CLIFTON
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State | NJ
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Zip | 07011-2157
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Country | US
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Telephone | 973-340-6200
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Fax | 973-340-6204
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE/OWNER
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Name | MR. YOUNIS RASHEED
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Credential | R.PH.
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Telephone | 210-410-0002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28RS00670700
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License Number State | NJ
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