MEDICARE: AMEEN PHARMACY

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	28RS000687100	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2118769	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619114170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMEEN PHARMACY

Provider Business Mailing Address
First Line	:	7527 BERGENLINE AVE
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-5459
Country	:	US
Telephone Number	:	201-751-4500
Fax Number	:	201-751-4499

Provider Business Practice Location Address
First Line	:	7527 BERGENLINE AVE
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-5459
Country	:	US
Telephone Number	:	201-751-4500
Fax Number	:	201-751-4499

Authorized Official
Title or Position	:	PHARMACIST-IN-CHARGE/OWNER
Name	:	OMAR JALUDI
Credential	:
Telephone Number	:	201-751-4500

Provider Enumeration Date	:	01/20/2009
Last Update Date	:	07/19/2018

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Directions to “AMEEN PHARMACY ” Practice Location

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