Active NPI
Mt Prospect Pharmaceutical Services Inc
Doing business as Liss Pharmacy
- Community/Retail Pharmacy
- Newark, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 28RS00225300
- Legal business name
- MT PROSPECT PHARMACEUTICAL SERVICES INC
- Doing business as
- Liss Pharmacy
- Practice address
- 794 Mount Prospect Ave
Newark, NJ 07104-3221 - Phone
- (973) 483-4749
- Fax
- (973) 482-0643
- NPI assigned
- Sep 7, 2006
- Last updated
- Sep 11, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Matthew Joseph Parisi Jr.
- Title
- Owner
- Phone
- (973) 483-4749
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NJ | ||
| Community/Retail Pharmacy | 3336C0003X | 28RS00225300 | NJ | Primary |
Addresses
Primary practice location
794 Mount Prospect Ave
Newark, NJ 07104-3221
Mailing address
794 Mount Prospect Ave
Newark, NJ 07104-3221
Phone (973) 483-4749
Other names 1
- Liss Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090202000403 | NJ | Part B Supplier - Mass Immunization (Roster Biller Only) | 9133283450 | Practice locations: Newark, NJ |
| O20100930028378 | NJ | DME Supplier - Pharmacy | 9133283450 | Practice locations: Newark, NJ |
National Provider Directory
National Provider DirectoryLocations
794 Mount Prospect Ave
Newark, NJ 07104
Phone (973) 483-4749
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.
-
- Pharmacist
- Newark, NJ
- NPI 1306057864
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1505088000000",
"number": "1083717482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "794 MOUNT PROSPECT AVE",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071043221",
"telephone_number": "973-483-4749",
"fax_number": "973-482-0643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "794 MOUNT PROSPECT AVE",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071043221",
"telephone_number": "973-483-4749",
"fax_number": "973-482-0643"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MT PROSPECT PHARMACEUTICAL SERVICES INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-07",
"last_updated": "2017-09-11",
"status": "A",
"authorized_official_last_name": "PARISI",
"authorized_official_first_name": "MATTHEW",
"authorized_official_middle_name": "JOSEPH",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "973-483-4749",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NJ",
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NJ",
"license": "28RS00225300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Liss Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Newark, NJ
- Latashia Mozee, CNA
- Josephine Joanna-Marie Mozia, LSW
- Mrs. Oddie's Social Day Care Center
- Mt Carmel Guild Behavioral Healthcare
- Mt Prospect Pharmaceutical Services Inc
- Mt Prospect Pharmacy Corp (Mt Prospect Pharmacy)
- Mt Prospect Pharmacy Corp
- Mt. Carmel Guild - Pact
- Mt. Carmel Guild Engle Center
- Derya Mucahit, DO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2017; 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.