Organization
FIVE CORNERS PHARMACY LLP
Active
Other names
Five Corners Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
AMIR / HANI TADROS (PHARMACIST/ OWNERS)
(201) 217-0092
Entity
Organization
Contact information
Practice address
591 SUMMIT AVE. STORE #1, JERSEY CITY, NJ 07306
(201) 217-0092
(201) 217-0093
Mailing address
591 SUMMIT AVE. STORE #1, JERSEY CITY, NJ 07306
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00687300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3195585
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/10/2009
Last updated
02/10/2009
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