MEDICARE: ST. PETER'S PHARMACY & DRUGS LLC

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	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1467275404
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. PETER'S PHARMACY & DRUGS LLC

Provider Business Mailing Address
First Line	:	1000 WASHINGTON ST
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-5202
Country	:	US
Telephone Number	:	201-659-8492
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 WASHINGTON ST
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-5202
Country	:	US
Telephone Number	:	201-659-8492
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	WAEL NABIL ISAAC
Credential	:
Telephone Number	:	718-210-6113

Provider Enumeration Date	:	11/07/2024
Last Update Date	:	09/26/2025

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