Provider Demographics
NPI:1164736914
Name:DRUGSMART PHARMACY LLC
Entity Type:Organization
Organization Name:DRUGSMART PHARMACY LLC
Other - Org Name:DRUGSMART PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEYUR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:732-769-5550
Mailing Address - Street 1:300 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KEANSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:07734-2033
Mailing Address - Country:US
Mailing Address - Phone:732-769-5550
Mailing Address - Fax:732-769-5549
Practice Address - Street 1:300 MAIN ST
Practice Address - Street 2:
Practice Address - City:KEANSBURG
Practice Address - State:NJ
Practice Address - Zip Code:07734-2033
Practice Address - Country:US
Practice Address - Phone:732-769-5550
Practice Address - Fax:732-769-5549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS007056003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0246735Medicaid
2125974OtherPK
2125974OtherPK