MEDICARE: CORNERSTONE PHARMACY 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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	28RS00384200	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
2	2137391	OTHER		PK

General Provider Information

NPI Number	:	1689657744
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORNERSTONE PHARMACY LLC

Provider Business Mailing Address
First Line	:	PO BOX 478
Second Line	:
City	:	MENDHAM
State	:	NJ
Zip	:	07945-0478
Country	:	US
Telephone Number	:	973-543-2525
Fax Number	:	973-543-2396

Provider Business Practice Location Address
First Line	:	27 E MAIN ST
Second Line	:
City	:	MENDHAM
State	:	NJ
Zip	:	07945-1538
Country	:	US
Telephone Number	:	973-543-2525
Fax Number	:	973-543-2396

Authorized Official
Title or Position	:	MEMBER
Name	:	NIDA MOHAMMAD
Credential	:
Telephone Number	:	973-543-2525

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	02/20/2026

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Directions to “CORNERSTONE PHARMACY LLC ” Practice Location

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