Provider Demographics
NPI:1942351747
Name:EDISON DRUGS & SURGICAL INC
Entity Type:Organization
Organization Name:EDISON DRUGS & SURGICAL INC
Other - Org Name:TOWN DRUGS & SURGICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN-CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:PADMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-387-2665
Mailing Address - Street 1:238 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-4324
Mailing Address - Country:US
Mailing Address - Phone:732-324-4200
Mailing Address - Fax:732-324-4201
Practice Address - Street 1:164 SMITH ST
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-4312
Practice Address - Country:US
Practice Address - Phone:732-324-4200
Practice Address - Fax:732-324-4201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1106600001332B00000X
NJ2ZRS00651300333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22RS00651300OtherPHARMACY
NJ0598968Medicaid
1H9751OtherMEDICARE MASS IMMUNIZATION
3137850OtherNABP