Texas Road Old Bridge LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00674300 Issued in NJ

Legal business name

TEXAS ROAD OLD BRIDGE LLC

Practice address

1183 Englishtown Rd
Old Bridge, NJ 08857-1319

Phone

(732) 723-1101

Fax

(732) 723-1141

NPI assigned

Oct 5, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Amr Hillal

Title

Owner

Phone

(732) 723-1101

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• TEXAS ROAD PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ2 enrollments

Enrollment records 2

Tax ID family

Texas Road Old Bridge LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Texas Road Old Bridge LLC

  • Pharmacy
  • Old Bridge, NJ
  • NPI 1619746450
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keith S Germaine, BS

  • Pharmacist
  • Old Bridge, NJ
  • NPI 1356491948
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698969600000",
    "number": "1003004904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1183 ENGLISHTOWN RD",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088571319",
            "telephone_number": "732-723-1101",
            "fax_number": "732-723-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1183 ENGLISHTOWN RD",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088571319",
            "telephone_number": "732-723-1101",
            "fax_number": "732-723-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS ROAD OLD BRIDGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2023-11-03",
        "certification_date": "2023-10-27",
        "status": "A",
        "authorized_official_last_name": "HILLAL",
        "authorized_official_first_name": "AMR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-723-1101"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00674300",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0162329",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2056179",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TEXAS ROAD PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TEXAS ROAD PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amisha N Tailor, MD
• Matthew Tangel, MD
• Renata Tatgenhorst, DPT
• Tender Smiles of Old Bridge PA
• Sara Lynn Teplitsky
• Texas Road Old Bridge LLC
• Nilkanth Thaker
• The Arc Middlesex County
• The Covenant Mind Services LLC
• The Laboratory Solution New Jersey LLC

• Community/Retail Pharmacy in Old Bridge, NJ
• Providers in Old Bridge, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.