Organization Active NPI

Konicy Corp

  • Community/Retail Pharmacy
  • Newark, NJ
National Provider Identifier
1104425941
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
KONICY CORP
Practice address
130 Summer Ave
Newark, NJ 07104-1903
Phone
(973) 350-6155
NPI assigned
Oct 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Authorized official

Name
Jephte Alexander
Title
Pic
Phone
(973) 350-6155

Specialties & licenses 1

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

Addresses

Primary practice location

130 Summer Ave
Newark, NJ 07104-1903

Mailing address

130 Summer Ave
Newark, NJ 07104-1903
Phone (973) 350-6155

Other names 1

  • Apollo Pharmacy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615161600000",
    "number": "1104425941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SUMMER AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071041903",
            "telephone_number": "973-350-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 SUMMER AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071041903",
            "telephone_number": "973-350-6155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KONICY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-22",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "JEPHTE",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "973-350-6155"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Apollo Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Apollo Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.