Provider Demographics
NPI:1255484861
Name:DORSI'S DELI & PHARMACY INC
Entity Type:Organization
Organization Name:DORSI'S DELI & PHARMACY INC
Other - Org Name:DORSI'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DORSI
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:908-647-7878
Mailing Address - Street 1:184 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:STIRLING
Mailing Address - State:NJ
Mailing Address - Zip Code:07980-1233
Mailing Address - Country:US
Mailing Address - Phone:908-647-7878
Mailing Address - Fax:908-647-8585
Practice Address - Street 1:184 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:STIRLING
Practice Address - State:NJ
Practice Address - Zip Code:07980-1233
Practice Address - Country:US
Practice Address - Phone:908-647-7878
Practice Address - Fax:908-647-8585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS004591003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4984501Medicaid
NJ0584420001Medicare ID - Type Unspecified
NJ4984501Medicaid