NPIMap

Organization Active NPI

Jackson Village Pharmacy LLC

Doing business as Hackensack Meridian Village Pharmacy

  • Community/Retail Pharmacy
  • Jackson, NJ
National Provider Identifier
1477955037
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
JACKSON VILLAGE PHARMACY LLC
Doing business as
Hackensack Meridian Village Pharmacy
Meridian Village Pharmacy at Jackson
Practice address
27 S Cooks Bridge Rd Ste 1-1
Jackson, NJ 08527-2460
Phone
(732) 994-7387
NPI assigned
Sep 25, 2014
Last updated
Feb 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Authorized official

Name
Mr. Gabriel Ouellette, PHARMACISTNPI 1386247104
Title
Manager / Owner
Phone
(860) 367-3387

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Clinic Pharmacy 3336C0002X NU
Community/Retail Pharmacy 3336C0003X NJ Primary
Long Term Care Pharmacy 3336L0003X NU
Specialty Pharmacy 3336S0011X NU

Addresses

Primary practice location

27 S Cooks Bridge Rd Ste 1-1
Jackson, NJ 08527-2460

Mailing address

27 S Cooks Bridge Rd Ste M1
Jackson, NJ 08527-2443
Phone (732) 994-7387

Other practice location 1

27 South Cooks Bridge Rd
Suite M1
Jackson, NJ 08527
Phone (732) 994-7387

Other names 2

  • Hackensack Meridian Village Pharmacy Doing business as
  • Meridian Village Pharmacy at Jackson Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160806000117 NJ DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 8325332869 Practice locations: Jackson, NJ
O20161116001099 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 8325332869 Practice locations: Jackson, NJ

National Provider Directory

National Provider Directory
Tax ID family
Hackensack Meridian Village Pharmacy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770854400000",
    "number": "1477955037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 S COOKS BRIDGE RD STE M1",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272443",
            "telephone_number": "732-994-7387",
            "fax_number": "732-994-7389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 S COOKS BRIDGE RD STE 1-1",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272460",
            "telephone_number": "732-994-7387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27 South Cooks Bridge Rd",
            "address_2": "Suite M1",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "NJ",
            "postal_code": "08527",
            "country_code": "US",
            "telephone_number": "732-994-7387",
            "fax_number": "732-994-7389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JACKSON VILLAGE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-25",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A",
        "authorized_official_last_name": "OUELLETTE",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_title_or_position": "MANAGER / OWNER",
        "authorized_official_telephone_number": "860-367-3387",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hackensack Meridian Village Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Meridian Village Pharmacy at Jackson",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Meridian Village Pharmacy at Jackson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.