# MORT JACOBS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mort Jacobs Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417095613
- **Authorized official:** BHAVINI SHAH (PIC)
- **Authorized official phone:** (973) 279-4600

## Contact information

- **Practice address:** 506 PARK AVE, PATERSON, NJ 07504-1532
- **Practice address phone:** (973) 279-4600
- **Mailing address:** 506 PARK AVE, PATERSON, NJ 07504-1532
- **Mailing address phone:** (973) 279-4600
- **Mailing address fax:** (973) 278-2666

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 28RS00648000 | NJ | Yes |

## Other

- **Enumeration date:** 02/01/2007
- **Last updated:** 02/22/2026