MEDICARE: MEDLIFE PHARMACY 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	333600000X	Pharmacy
2	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1891595617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDLIFE PHARMACY INC

Provider Business Mailing Address
First Line	:	2000 STATE ROUTE 27 STE C
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-1384
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 STATE ROUTE 27 STE C
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-1384
Country	:	US
Telephone Number	:	732-658-3636
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MAYEZ ENVER
Credential	:
Telephone Number	:	732-658-3636

Provider Enumeration Date	:	03/19/2025
Last Update Date	:	03/19/2025

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