Provider Demographics
NPI:1598040875
Name:DIRECT MEDS OF JERSEY CITY LLC
Entity Type:Organization
Organization Name:DIRECT MEDS OF JERSEY CITY LLC
Other - Org Name:DIRECT MEDS OF JERSEY CITY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MUNAR
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZMIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-585-9234
Mailing Address - Street 1:26 GREENVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-2608
Mailing Address - Country:US
Mailing Address - Phone:201-333-3527
Mailing Address - Fax:201-333-3524
Practice Address - Street 1:26 GREENVILLE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-2608
Practice Address - Country:US
Practice Address - Phone:201-333-3527
Practice Address - Fax:201-333-3524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-18
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS007466003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2133356OtherPK