MEDICARE: AJ 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	PHY 53739	CA

General Provider Information

NPI Number	:	1760932131
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AJ PHARMACY, LLC

Provider Business Mailing Address
First Line	:	788 MORRIS TPKE FL 3
Second Line	:
City	:	SHORT HILLS
State	:	NJ
Zip	:	07078-2637
Country	:	US
Telephone Number	:	973-869-2820
Fax Number	:

Provider Business Practice Location Address
First Line	:	4201 TORRANCE BLVD
Second Line	:	SUITE 210
City	:	TORRANCE
State	:	CA
Zip	:	90503-4537
Country	:	US
Telephone Number	:	310-543-1111
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT & OFFICER
Name	:	MR. ANUSH AMIN
Credential	:
Telephone Number	:	973-869-2820

Provider Enumeration Date	:	10/10/2016
Last Update Date	:	02/06/2025

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