Provider Demographics
NPI:1679200521
Name:SHREEJI PHARMACY LLC
Entity Type:Organization
Organization Name:SHREEJI PHARMACY LLC
Other - Org Name:
Other - Org Type:
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:
Authorized Official - Phone:732-946-1600
Mailing Address - Street 1:479 COUNTY ROAD 520 STE A102
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1086
Mailing Address - Country:US
Mailing Address - Phone:732-946-1600
Mailing Address - Fax:732-946-1001
Practice Address - Street 1:479 COUNTY ROAD 520 STE A102
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1086
Practice Address - Country:US
Practice Address - Phone:732-946-1600
Practice Address - Fax:732-946-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0605115Medicaid