Provider Demographics
NPI:1497776454
Name:MEERA INC
Entity Type:Organization
Organization Name:MEERA INC
Other - Org Name:GIANNOTTO'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST , COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AVANI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-482-8220
Mailing Address - Street 1:PO BOX 110
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-0110
Mailing Address - Country:US
Mailing Address - Phone:973-482-8220
Mailing Address - Fax:973-482-0615
Practice Address - Street 1:195 1ST AVE WEST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107-2618
Practice Address - Country:US
Practice Address - Phone:973-482-8220
Practice Address - Fax:973-482-0615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0003X, 3336S0011X
MO20170338983336S0011X
NHNR14763336S0011X
MN2653273336S0011X
NDPHAR14193336S0011X
HIPMP-14323336S0011X
DEA9-00019863336S0011X
MTPHA-MOP-LIC-475533336S0011X
NC132883336S0011X
ID46045MS3336S0011X
FLPH308283336S0011X
AK1235823336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7270305 - RXMedicaid
NJ7270313 - DMEMedicaid
2054411OtherPK