Provider Demographics
NPI:1114422102
Name:PHARMACY EXPRESS INC
Entity Type:Organization
Organization Name:PHARMACY EXPRESS INC
Other - Org Name:PHARMACY EXPRESS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEMHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-590-7819
Mailing Address - Street 1:991 MAIN ST
Mailing Address - Street 2:UNIT 1B
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-2224
Mailing Address - Country:US
Mailing Address - Phone:973-754-1000
Mailing Address - Fax:973-754-1010
Practice Address - Street 1:991 MAIN ST
Practice Address - Street 2:UNIT 1B
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-2224
Practice Address - Country:US
Practice Address - Phone:973-754-1000
Practice Address - Fax:973-754-1010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-29
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
NJ28RS007619003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2176797OtherPK
NJN/AMedicaid