Quick Mart Pharmacy & Convenience LLC

Key facts

NPI

1073165403

Entity type

Organization (NPI type 2)

Primary specialty

Community/Retail Pharmacy 3336C0003X

Legal business name

QUICK MART PHARMACY & CONVENIENCE LLC

Practice address

100 Ryders LN Ste 5
Milltown, NJ 08850-1263

Phone

(732) 745-7222

Fax

(732) 545-4402

NPI assigned

Jul 16, 2019

Organization subpart

No

Authorized official

Name

Alok Patel, PHARMACIST

Title

Member-LLC

Phone

(732) 745-7222

Practitioners 2

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

• Ritesh D Patel Pharmacist · Milltown, NJ · NPI 1356921886
  NPD
• Diane Jean Ivanov, LCSW Clinical Social Worker · Milltown, NJ · NPI 1932183100
  NPD (past)

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 16, 2019.

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563235200000",
    "number": "1073165403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RYDERS LN STE 5",
            "city": "MILLTOWN",
            "state": "NJ",
            "postal_code": "088501263",
            "telephone_number": "732-745-7222",
            "fax_number": "732-545-4402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RYDERS LN STE 5",
            "city": "MILLTOWN",
            "state": "NJ",
            "postal_code": "088501263",
            "telephone_number": "732-745-7222",
            "fax_number": "732-545-4402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUICK MART PHARMACY & CONVENIENCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-16",
        "last_updated": "2019-07-16",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "ALOK",
        "authorized_official_title_or_position": "MEMBER-LLC",
        "authorized_official_telephone_number": "732-745-7222",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0437395",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Milltown, NJ · Community/Retail Pharmacy in New Jersey