| NPI | 1639102940 |
|---|---|
| Doing Business As | JERRYS DRUG & SURGICAL SUPPLY |
| Entity Type | Organization |
| Authorized Contact | MICHAEL L BOLOGH Owner 201-339-1992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NJ 28RS00532100) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NJ 28RS00532100) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NJ 28RS00532100) | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2010-03-11 |