<Unavail>
LBN: 21St Ave Pharmacy Inc.
<Unavail> is an health care organization with primary practice located at 357 21St Ave , Paterson NJ 07501-3642. The organization recently has 3 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
21St Ave Pharmacy Inc. can be contacted via phone (973) 742-1235, or through Rodriguez, Antonio Orestes via phone (973) 742-1235.
Contact Information
Primary practice address
357 21St Ave
Paterson NJ 07501-3642
Phone: (973) 742-1235
Fax: (973) 742-0353
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 28RS00334800 | New Jersey |
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | 28RS003348 | New Jersey |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 28RS003348 | New Jersey |
Profile Details
| NPI number | 1336124593 |
|---|---|
| LBN Legal business name | 21St Ave Pharmacy Inc. |
| DBA Doing business as | <Unavail> |
| Authorized official | Rodriguez, Antonio Orestes |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 9th, 2005 |
| Last updated | Feb 19th, 2009 - about 17 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336124593 | NPPES |
| New Jersey | MEDICAID | 0107905 | |
| New Jersey | MEDICAID | 4344600 |
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