MEDICARE: MAGIC RX PLUS, INC.

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	332BC3200X	Customized Equipment (DME)
2	332B00000X	Durable Medical Equipment & Medical Supplies

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

General Provider Information

NPI Number	:	1881450880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAGIC RX PLUS, INC.

Provider Business Mailing Address
First Line	:	2468 LEMOINE AVE
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-6206
Country	:	US
Telephone Number	:	201-944-1002
Fax Number	:	201-944-6336

Provider Business Practice Location Address
First Line	:	2468 LEMOINE AVE
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-6206
Country	:	US
Telephone Number	:	201-944-1002
Fax Number	:	201-944-6336

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WONYOL CHANG
Credential	:	RPH
Telephone Number	:	201-944-1002

Provider Enumeration Date	:	02/27/2024
Last Update Date	:	02/27/2024

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Directions to “MAGIC RX PLUS, INC. ” Practice Location

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