MEDICARE: DIRECT MEDS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	28RS00569300	NJ
2	333600000X	Pharmacy	28RS00569300	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457461444
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIRECT MEDS INC

Provider Business Mailing Address
First Line	:	345 GRAND AVE
Second Line	:
City	:	LEONIA
State	:	NJ
Zip	:	07605-2238
Country	:	US
Telephone Number	:	201-585-0616
Fax Number	:

Provider Business Practice Location Address
First Line	:	345 GRAND AVE
Second Line	:
City	:	LEONIA
State	:	NJ
Zip	:	07605-2238
Country	:	US
Telephone Number	:	201-585-0616
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MUNR KAZMIR
Credential	:
Telephone Number	:	201-585-9234

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	05/13/2009

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Directions to “DIRECT MEDS INC ” Practice Location

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