Organization Active NPI

Payless Pharmacy LLC

  • Community/Retail Pharmacy
  • Linden, NJ
National Provider Identifier
1558041020
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PAYLESS PHARMACY LLC
Practice address
222 N Wood Ave
Linden, NJ 07036-4220
Phone
(908) 587-2000
Fax
(908) 357-2960
NPI assigned
Jul 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Authorized official

Name
Mohammed Khedr, RPHNPI 1801579081
Title
Managing Member
Phone
(908) 587-2000

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

222 N Wood Ave
Linden, NJ 07036-4220

Mailing address

222 N Wood Ave
Linden, NJ 07036-4220
Phone (908) 587-2000

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230927001769 NJ Part B Supplier - Pharmacy 2961856711 Practice locations: Linden, NJ
O20250605000258 NJ DME Supplier - Pharmacy 2961856711 Practice locations: Linden, 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
Payless Pharmacy LLC222 N Wood Ave, Linden, NJ 07036-4220(908) 587-2000 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Aug 23, 2023

National Provider Directory

National Provider Directory

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": "1689811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744070400000",
    "number": "1558041020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 N WOOD AVE",
            "city": "LINDEN",
            "state": "NJ",
            "postal_code": "070364220",
            "telephone_number": "908-587-2000",
            "fax_number": "908-357-2960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N WOOD AVE",
            "city": "LINDEN",
            "state": "NJ",
            "postal_code": "070364220",
            "telephone_number": "908-587-2000",
            "fax_number": "908-357-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAYLESS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-20",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A",
        "authorized_official_last_name": "KHEDR",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "908-587-2000",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Linden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.