Grand Street Pharmacy LLC
NPI 1366893851ActiveOrganization· Pharmacy· Paterson, NJ
Pharmacy in Paterson, New Jersey, registered in NPPES in June 2016. The authorized official on file is Ramesh Gajjar, Owener. Enrolled in Medicare as dme supplier - pharmacy and part b supplier - mass immunization (roster biller only).
Overview
| NPI | 1366893851 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 26, 2016 |
| Last updated in NPPES | Apr 4, 2022 |
| Certified by provider | Apr 4, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | 28RS00751800 | NJ |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (NJ); Part B Supplier - Mass Immunization (Roster Biller Only) (NJ) |
|---|
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