Provider Demographics
NPI:1447315700
Name:NORMANS PHARMACY INC
Entity type:Organization
Organization Name:NORMANS PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DUSHYANT
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:201-435-8112
Mailing Address - Street 1:501 JERSEY AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-3457
Mailing Address - Country:US
Mailing Address - Phone:201-435-8112
Mailing Address - Fax:201-435-8113
Practice Address - Street 1:501 JERSEY AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-3457
Practice Address - Country:US
Practice Address - Phone:201-435-8112
Practice Address - Fax:201-435-8113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS003602003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4358902Medicaid
3126617OtherNCPPP NABP
NJ4358902Medicaid