Provider Demographics
NPI:1720077795
Name:2M HOLDINGS LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:2M HOLDINGS LIMITED PARTNERSHIP
Other - Org Name:WICKEPECKO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ABE
Authorized Official - Middle Name:
Authorized Official - Last Name:MERMELSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:BS PHARM
Authorized Official - Phone:732-776-6070
Mailing Address - Street 1:1409 WICKAPECKO DR
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4201
Mailing Address - Country:US
Mailing Address - Phone:732-776-6070
Mailing Address - Fax:732-776-6040
Practice Address - Street 1:1409 WICKAPECKO DR
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-4201
Practice Address - Country:US
Practice Address - Phone:732-776-6070
Practice Address - Fax:732-776-6040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-20
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336S0011X
NJ28RS006449003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0054330Medicaid
2152980OtherPK
NJ00544330Medicaid