Organization Active NPI

South Orange Healthcare Co

  • Community/Retail Pharmacy
  • South Orange, NJ
National Provider Identifier
1104770650
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SOUTH ORANGE HEALTHCARE CO
Practice address
73 S Orange Ave
South Orange, NJ 07079-1715
Phone
(973) 821-5414
Fax
(973) 275-5220
NPI assigned
Feb 23, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

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

Authorized official

Name
Ali Mujahid
Title
Owner/President
Phone
(973) 821-5414

Specialties & licenses 1

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

Addresses

Primary practice location

73 S Orange Ave
South Orange, NJ 07079-1715

Mailing address

73 S Orange Ave
South Orange, NJ 07079-1715
Phone (973) 821-5414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20260601003208 NJ Part B Supplier - Pharmacy 9739659699 Practice locations: South Orange, NJ
O20260615000069 NJ DME Supplier - Pharmacy 9739659699 Practice locations: South Orange, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
South Orange Healthcare Co73 S Orange Ave, South Orange, NJ 07079-1715(973) 821-5414 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jun 15, 2026

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1771804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771804800000",
    "number": "1104770650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 S ORANGE AVE",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791715",
            "telephone_number": "973-821-5414",
            "fax_number": "973-275-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 S ORANGE AVE",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791715",
            "telephone_number": "973-821-5414",
            "fax_number": "973-275-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ORANGE HEALTHCARE CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-23",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A",
        "authorized_official_last_name": "MUJAHID",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "973-821-5414"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.