Provider Demographics
NPI:1770248460
Name:BOZOGLU LLC
Entity type:Organization
Organization Name:BOZOGLU LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOZOGLU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-518-8897
Mailing Address - Street 1:295 OLYMPIA DR
Mailing Address - Street 2:
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-1121
Mailing Address - Country:US
Mailing Address - Phone:212-518-8897
Mailing Address - Fax:973-837-8189
Practice Address - Street 1:57 NJ 23
Practice Address - Street 2:UNIT 8
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470
Practice Address - Country:US
Practice Address - Phone:973-837-8188
Practice Address - Fax:973-837-8189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJB69334310004792OtherDRIVER LICENSE