Organization Active NPI

Riverwalk Pharmacy LLC

Doing business as Riverwalk Pharmacy

  • Community/Retail Pharmacy
  • Basking Ridge, NJ
National Provider Identifier
1053894196
Registry record updated Nov 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
RIVERWALK PHARMACY LLC
Doing business as
Riverwalk Pharmacy
Practice address
665 Marinsville Rd Unite 9B
Basking Ridge, NJ 07920
Phone
(862) 400-7897
Fax
(908) 312-5354
NPI assigned
Sep 14, 2018
Last updated
Nov 26, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2018

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

Authorized official

Name
Marwa Samaha
Title
Pharmacist in Charge
Phone
(908) 312-5353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

665 Marinsville Rd Unite 9B
Basking Ridge, NJ 07920

Mailing address

63 Barbara St
Bloomfield, NJ 07003-4001
Phone (862) 400-7897

Other names 1

  • RIVERWALK PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181119002349 NJ Part B Supplier - Pharmacy 5799039228 Practice locations: Basking Ridge, NJ

National Provider Directory

National Provider Directory

Locations

665 Martinsville Rd
#9B
Basking Ridge, NJ 07920
Phone (862) 400-7897

665 Martinsville Rd
Ste 9B
Basking Ridge, NJ 07920
Phone (908) 312-5353

Practitioners & affiliated clinicians

Practitioners 1

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": "1536883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543190400000",
    "number": "1053894196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 BARBARA ST",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034001",
            "telephone_number": "862-400-7897",
            "fax_number": "908-312-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 MARINSVILLE RD UNITE 9B",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "07920",
            "telephone_number": "862-400-7897",
            "fax_number": "908-312-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERWALK PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-14",
        "last_updated": "2018-11-26",
        "status": "A",
        "authorized_official_last_name": "SAMAHA",
        "authorized_official_first_name": "MARWA",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "908-312-5353"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RIVERWALK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "RIVERWALK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Basking Ridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; 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.