Acme Markets Inc
Organization Active NPI Community/Retail Pharmacy · Fort Lee, NJ
NPI 1063889350 · NPPES record last updated Jul 24, 2018
Key facts
- NPI
- 1063889350
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 28RS00545000 (NJ)
- Legal business name
- ACME MARKETS INC
- Practice address
- 2160 Lemoine Ave
Fort Lee, NJ 07024 - Phone
- (201) 944-1466
- Fax
- (201) 944-1558
- NPI assigned
- Aug 21, 2015
- Organization subpart
- No
Authorized official
- Name
- Tiffany Eliopulos
- Title
- Assistant Manager, Enrollments
- Phone
- (208) 395-3906
Corporate family (same tax ID) 18
Member of 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160130000229 | NJ | DME Supplier - Pharmacy |
4082674940 | Practice locations: Fort Lee, NJ |
National Provider Directory
- Tax ID family
- Acme Markets Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 28RS00545000 | NJ | Yes |
Addresses
Primary practice location
2160 Lemoine Ave
Fort Lee, NJ 07024
Mailing address
250 E Parkcenter Blvd
Mailstop Sec2-B
Boise, ID 83706-3940
Phone (208) 395-3920
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2154235 | Other | PK | |
| 0519626 | Medicaid | NJ |
Other names
- ACME PHARMACY #1065
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- Abraham Abraham
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- Acme Markets Inc
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All providers in Fort Lee, NJ · Community/Retail Pharmacy in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.