Organization
MORT JACOBS INC
Active
Other names
Mort Jacobs Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BHAVINI SHAH (PIC)
(973) 279-4600
Entity
Organization
Contact information
Practice address
506 PARK AVE, PATERSON, NJ 07504-1532
(973) 279-4600
Mailing address
506 PARK AVE, PATERSON, NJ 07504-1532
(973) 279-4600
(973) 278-2666
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
28RS00648000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0069183
—
NJ
Enumeration date
02/01/2007
Last updated
02/22/2026
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