Provider Demographics
NPI:1679791081
Name:SZS III, INC
Entity type:Organization
Organization Name:SZS III, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:ZAGOREOS
Authorized Official - Suffix:
Authorized Official - Credentials:RP
Authorized Official - Phone:609-278-4100
Mailing Address - Street 1:321 N WARREN ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-4741
Mailing Address - Country:US
Mailing Address - Phone:609-278-4100
Mailing Address - Fax:609-278-6878
Practice Address - Street 1:321 N WARREN ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-4741
Practice Address - Country:US
Practice Address - Phone:609-278-4100
Practice Address - Fax:609-278-6878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS005372003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7081901Medicaid
NJ1324400001Medicare UPIN