Organization
JEMMISON CORP
Active
Other names
STATION PHARMACY WINES AND LIQUOR
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY ZNAK RPH (PRESIDENT)
(973) 589-9192
Entity
Organization
Contact information
Practice address
148 SOUTH ST, NEWARK, NJ 07114-2719
(973) 589-9192
(973) 589-6686
Mailing address
148 SOUTH ST, NEWARK, NJ 07114-2719
(973) 589-9192
(973) 589-6686
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS0035900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1576305
—
NJ
01
—
3126679
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
4358104
—
NJ
Enumeration date
10/20/2006
Last updated
10/26/2010
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