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NPI Code Detail

MEDICARE: DIRECT MEDS OF JERSEY CITY LLC

MEDICARE: DIRECT MEDS OF JERSEY CITY 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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy28RS00746600NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12133356OTHERPK

General Provider Information

NPI Number : 1598040875
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIRECT MEDS OF JERSEY CITY LLC
Provider Business Mailing Address
First Line : 26 GREENVILLE AVE
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07305-2608
Country : US
Telephone Number : 201-333-3527
Fax Number : 201-333-3524
Provider Business Practice Location Address
First Line : 26 GREENVILLE AVE
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07305-2608
Country : US
Telephone Number : 201-333-3527
Fax Number : 201-333-3524
Authorized Official
Title or Position : CEO
Name : MUNAR KAZMIR
Credential :
Telephone Number : 201-585-9234
Provider Enumeration Date : 10/18/2011
Last Update Date : 01/22/2016

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Directions to “DIRECT MEDS OF JERSEY CITY LLC ” Practice Location

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