Organization Active NPI

Maywood RX Inc

  • Community/Retail Pharmacy
  • Maywood, NJ
National Provider Identifier
1144547142
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00702900 Issued in NJ
Legal business name
MAYWOOD RX INC
Practice address
102 W Pleasant Ave
Maywood, NJ 07607-1336
Phone
(201) 880-5290
Fax
(201) 880-5291
NPI assigned
Apr 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shemal Bodawala
Title
President
Phone
(201) 880-5290

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 28RS00702900 NJ Primary

Addresses

Primary practice location

102 W Pleasant Ave
Maywood, NJ 07607-1336

Mailing address

102 W Pleasant Ave
Maywood, NJ 07607-1336
Phone (201) 880-5290

Other identifiers 1

IdentifierTypeStateIssuer
1107038MedicaidNJ

Other names 1

  • maywood pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20241122002195 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 6002341369 Practice locations: Maywood, NJ
O20250408001080 NJ DME Supplier - Pharmacy 6002341369 Practice locations: Maywood, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Maywood RX Inc102 W Pleasant Ave, Maywood, NJ 07607-1336(201) 880-5290 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Oct 7, 2024

National Provider Directory

National Provider Directory

Locations

102 W Pleasant Ave
Maywood, NJ 07607
Phone (201) 880-5290

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754524800000",
    "number": "1144547142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W PLEASANT AVE",
            "city": "MAYWOOD",
            "state": "NJ",
            "postal_code": "076071336",
            "telephone_number": "201-880-5290",
            "fax_number": "201-880-5291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W PLEASANT AVE",
            "city": "MAYWOOD",
            "state": "NJ",
            "postal_code": "076071336",
            "telephone_number": "201-880-5290",
            "fax_number": "201-880-5291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYWOOD RX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-29",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A",
        "authorized_official_last_name": "BODAWALA",
        "authorized_official_first_name": "SHEMAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-880-5290"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00702900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1107038",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "maywood pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "maywood pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maywood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.