Provider Demographics
NPI:1790056653
Name:KALMUS, JACK (BS PHARMACY)
Entity Type:Individual
Prefix:MR
First Name:JACK
Middle Name:
Last Name:KALMUS
Suffix:
Gender:M
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:947 MEREDITH DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-3941
Mailing Address - Country:US
Mailing Address - Phone:732-270-2380
Mailing Address - Fax:
Practice Address - Street 1:37 JULIUSTOWN RD
Practice Address - Street 2:
Practice Address - City:BROWNS MILLS
Practice Address - State:NJ
Practice Address - Zip Code:08015-3627
Practice Address - Country:US
Practice Address - Phone:609-893-3191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01991500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist