OrganizationFive Corners Pharmacy Llp(<Unavail>)PharmacySuppliersPractice Address591 Summit Ave. Store #1, Jersey City, NJ 07306(201) 217-0092PECOS EnrollmentBased on the most recent information from CMS, provider Five Corners Pharmacy Llp does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1679712061Provider TypeOrganizationFull NameFive Corners Pharmacy LlpOther Name<Unavail>SubpartNoEnumeration Date2/10/2009Last Updated2/10/2009Contact InformationPractice LocationPractice Address591 Summit Ave. Store #1, Jersey City, NJ 07306Phone(201) 217-0092Fax(201) 217-0093Mailing LocationMailing Address591 Summit Ave. Store #1, Jersey City, NJ 07306PhoneUnlisted PhoneFaxUnlisted FaxAuthorized OfficialNameTadros, Amir / Hani (Pharmacist/ Owners)Phone(201) 217-0092Provider TaxonomiesCodeDescriptionLicenseCode3336C0003XPrimaryDescriptionPharmacySuppliersLicense28RS00687300New JerseyCode333600000XDescriptionPharmacySuppliersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID3195585DescriptionOtherIssuerNCPDP PROVIDER IDENTIFICATION NUMBER