Fort Lee Pharmacy & Surgical Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RS00613000 Issued in NJ

Legal business name

FORT LEE PHARMACY & SURGICAL INC

Doing business as

Fort Lee Pharmacy and Surgicals Inc
Fort Lee Pharmacy & Surgicals

Practice address

1562 Lemoine Ave
Fort Lee, NJ 07024-5652

Phone

(201) 346-9202

Fax

(201) 346-9212

NPI assigned

Aug 31, 2006

Last updated

Oct 4, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Myeongha Jo

Title

President

Phone

(201) 346-9202

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 2

• FORT LEE PHARMACY AND SURGICALS INC Doing business as
• Fort Lee Pharmacy & Surgicals Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

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.

• Maria C Domingues, O.D.

  • Optometrist
  • Irvington, NJ
  • NPI 1174820682
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1922110923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1562 LEMOINE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245652",
            "telephone_number": "201-346-9202",
            "fax_number": "201-346-9212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1562 LEMOINE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245652",
            "telephone_number": "201-346-9202",
            "fax_number": "201-346-9212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT LEE PHARMACY & SURGICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "JO",
        "authorized_official_first_name": "MYEONGHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-346-9202"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "RS00613000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8869103",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2055063",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FORT LEE PHARMACY AND SURGICALS INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fort Lee Pharmacy & Surgicals",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fort Lee Pharmacy & Surgicals",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fort Lee Internal Medicine PC
• Fort Lee Medical Center, Inc. (Fort Lee Surgery Center)
• Fort Lee Orthodontic Associates PC
• Fort Lee Pain Management LLC
• Fort Lee Pharmacy & Surgical Inc (Fort Lee Pharmacy & Surgicals)
• Fort Lee Physical Therapy, P.C.
• Fort Lee Podiatry Group LLC
• Fort Lee Rehabilitation
• Fort Lee Smiles
• Fort Lee Therapy Group

• Community/Retail Pharmacy in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.