Provider Demographics
NPI:1508222696
Name:DUNN MEADOW LLC
Entity Type:Organization
Organization Name:DUNN MEADOW LLC
Other - Org Name:DUNN MEADOW PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-676-3839
Mailing Address - Street 1:1555 CENTER AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-4612
Mailing Address - Country:US
Mailing Address - Phone:201-949-3400
Mailing Address - Fax:201-949-3455
Practice Address - Street 1:1555 CENTER AVE
Practice Address - Street 2:SUITE B
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-4612
Practice Address - Country:US
Practice Address - Phone:201-949-3400
Practice Address - Fax:201-949-3455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-06
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS007394003336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2157373OtherPK