Organization
SHAH ENTERPRISE INC
Active
Other names
MYERSON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SUBODH SHAH (PRESIDENT)
(201) 865-0844
Entity
Organization
Contact information
Practice address
1019 SUMMIT AVE, UNION CITY, NJ 07087-5511
(201) 865-0844
(201) 865-1003
Mailing address
1019 SUMMIT AVE, UNION CITY, NJ 07087-5511
(201) 865-0844
(201) 865-1003
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00505300
NJ
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2056892
PK
—
05
—
6409504
—
NJ
Enumeration date
12/18/2006
Last updated
08/02/2019
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