Organization
JEN PHARMA INC
Active
Other names
SUMMER AVENUE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SMITHA DASARI (PRESIDENT)
(973) 481-3388
Entity
Organization
Contact information
Practice address
205 SUMMER AVE, NEWARK, NJ 07104-2628
(973) 481-3388
(973) 481-0625
Mailing address
205 SUMMER AVE, NEWARK, NJ 07104-2628
(973) 481-3388
(973) 481-0625
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00706100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2126667
PK
—
Enumeration date
06/09/2006
Last updated
02/09/2023
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