Marlboro Village Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00726200 Issued in NJ

Legal business name

MARLBORO VILLAGE PHARMACY INC

Practice address

12 School Rd W
Marlboro, NJ 07746-1507

Phone

(732) 617-6060

Fax

(732) 719-2323

NPI assigned

Jul 27, 2012

Organization subpart

No

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

Authorized official

Name

Stansislav HishNPI 1962629956

Title

Pharmacist in Charge

Phone

(732) 617-6060

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Marlboro Village Pharmacy, Inc Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

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

• Stansislav Hish, R.PH.

  • Pharmacist
  • Marlboro, NJ
  • NPI 1962629956
  NPD Authorized official
• Benjamin Gelfand-Titiyevskiy, PHARMD

  • Pharmacist
  • Marlboro, NJ
  • NPI 1669307542
  NPD (past)

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609286400000",
    "number": "1003162041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SCHOOL RD W",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077461507",
            "telephone_number": "732-617-6060",
            "fax_number": "732-719-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 SCHOOL RD W",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077461507",
            "telephone_number": "732-617-6060",
            "fax_number": "732-719-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARLBORO VILLAGE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-27",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A",
        "authorized_official_last_name": "HISH",
        "authorized_official_first_name": "STANSISLAV",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "732-617-6060"
    },
    "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": "28RS00726200",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0406864",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2136249",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marlboro Village Pharmacy, Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Marlboro Village Pharmacy, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marlboro Family Eye Care, Inc.
• Marlboro First Aid & Rescue Squad Inc
• Marlboro Pediatric Care
• Marlboro Pediatric Dentistry, PC
• Marlboro Township Board of Ed
• Sandra Masino-Kalinowski, APN
• Julius Shea McAllister, DIRECT SUPPORT
• Car Douglas McClung, PHARMACIST
• Carolyn McDowell, APN
• Chelsea McGowan, OTD, OTR/L

• Community/Retail Pharmacy in Marlboro, NJ
• Providers in Marlboro, 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 Dec 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.