Organization Active NPI

C & S Pharmacy Ventures

Doing business as Quakerbridge Pharmacy

  • Community/Retail Pharmacy
  • Mercerville, NJ
National Provider Identifier
1053617977
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00710300 Issued in NJ
Legal business name
C & S PHARMACY VENTURES
Doing business as
Quakerbridge Pharmacy
Practice address
94 Flock Rd
Mercerville, NJ 08619-1471
Phone
(609) 587-1850
Fax
(609) 587-1852
NPI assigned
Feb 10, 2011
Last updated
Dec 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Authorized official

Name
Glenn SudnickNPI 1548932957
Title
Co-Owner
Phone
(609) 587-1850

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 28RS00710300 NJ Primary

Addresses

Primary practice location

94 Flock Rd
Mercerville, NJ 08619-1471

Mailing address

94 Flock Rd
Mercerville, NJ 08619-1471
Phone (609) 587-1850

Other identifiers 2

IdentifierTypeStateIssuer
0263117MedicaidNJ
2128817OtherPK

Other names 1

  • Quakerbridge Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220503000334 NJ Part B Supplier - Pharmacy 6305233818 Practice locations: Mercerville, NJ

National Provider Directory

National Provider Directory

Locations

94 Flock Rd
Trenton, NJ 08619
Phone (609) 587-1850

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1297296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418169600000",
    "number": "1053617977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 FLOCK RD",
            "city": "MERCERVILLE",
            "state": "NJ",
            "postal_code": "086191471",
            "telephone_number": "609-587-1850",
            "fax_number": "609-587-1852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 FLOCK RD",
            "city": "MERCERVILLE",
            "state": "NJ",
            "postal_code": "086191471",
            "telephone_number": "609-587-1850",
            "fax_number": "609-587-1852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C & S PHARMACY VENTURES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-10",
        "last_updated": "2014-12-10",
        "status": "A",
        "authorized_official_last_name": "SUDNICK",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "609-587-1850"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00710300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0263117",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2128817",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quakerbridge Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mercerville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; 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.