Crystal Drugs Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00659600 Issued in NJ

Legal business name

CRYSTAL DRUGS INC

Doing business as

NICKS DRUGS

Practice address

179 Market St
Newark, NJ 07102

Phone

(973) 596-1800

Fax

(973) 596-1849

NPI assigned

Jul 22, 2006

Organization subpart

No

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

Authorized official

Name

Narendar Reddy YasaNPI 1184731762

Title

Owner

Phone

(973) 596-1800

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• NICKS DRUGS Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

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

Locations

Practitioners 1

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

• Narendar Reddy Yasa, PHARMACIST

  • Pharmacist
  • Elizabeth, NJ
  • NPI 1184731762
  NPD Authorized official

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528243200000",
    "number": "1124049184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 MARKET ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071023707",
            "telephone_number": "973-596-1800",
            "fax_number": "973-596-1849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 MARKET ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07102",
            "telephone_number": "973-596-1800",
            "fax_number": "973-596-1849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL DRUGS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2018-06-06",
        "status": "A",
        "authorized_official_last_name": "YASA",
        "authorized_official_first_name": "NARENDAR",
        "authorized_official_middle_name": "REDDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-596-1800"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00659600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3135414",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0103837",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NICKS DRUGS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NICKS DRUGS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard W Crowley, DDS
• Crusaders Healthcare Corporation
• Damarys Cruz, FNP-BC, MSN
• Imelda Gina Laforteza Cruz, APN
• Katie T Cruz, M.A, LPC
• Yoel Cuba Crespo
• Jileya A Cudjoe
• Ashlee Culver
• Maria Flor Cunha, APN
• Tawanda Michelle Cunningham-Blakeney, MS ED

• Community/Retail Pharmacy in Newark, NJ
• Providers in Newark, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.