Organization
MEDINA PHARMACY INC
Active
Other names
Omar's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
E DIPERNA RPH (PHARMACIST IN CHARGE)
(862) 297-9111
Entity
Organization
Contact information
Practice address
540 STRAIGHT ST, PATERSON, NJ 07503-3239
(862) 297-9111
Mailing address
540 STRAIGHT ST, PATERSON, NJ 07503-3239
(862) 297-9111
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28RS00776700
BOARD OF PHARMACY
NJ
Enumeration date
05/08/2020
Last updated
08/07/2025
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