1255494324 NPI number — SHREE YASH CORP

Table of content: MS. JOYCE DYE LPN (NPI 1811024334)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255494324 NPI number — SHREE YASH CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHREE YASH CORP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255494324
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
338 PALISADE AVE
Provider Second Line Business Mailing Address:
PALISADE DRUGS
Provider Business Mailing Address City Name:
JERSEY CITY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07307-1719
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-222-9399
Provider Business Mailing Address Fax Number:
201-222-0255

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
338 PALISADE AVE
Provider Second Line Business Practice Location Address:
PALISADE DRUGS
Provider Business Practice Location Address City Name:
JERSEY CITY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07307-1753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-222-9399
Provider Business Practice Location Address Fax Number:
201-222-0255
Provider Enumeration Date:
12/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PATEL
Authorized Official First Name:
VIPUL
Authorized Official Middle Name:
H
Authorized Official Title or Position:
PRESIDENT PHARMACIST IN CHARGE
Authorized Official Telephone Number:
201-222-9399

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  28RS00648700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X , with the licence number: 28RS00648700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0072117 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com