NPIMap

Organization Active NPI

Nicobella Pharmacy LLC

  • Community/Retail Pharmacy
  • Long Branch, NJ
National Provider Identifier
1124125059
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00412800 Issued in NJ
Legal business name
NICOBELLA PHARMACY LLC
Practice address
444 Ocean Blvd. N.
Long Branch, NJ 07740
Phone
(732) 222-1299
Fax
(732) 222-7884
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Authorized official

Name
Mr. Carlos AlmanzaNPI 1942524798
Title
Owner/Officer
Phone
(732) 222-1299

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 28RS00412800 NJ Primary

Addresses

Primary practice location

444 Ocean Blvd. N.
Long Branch, NJ 07740

Mailing address

444 Ocean Blvd. N.
Long Branch, NJ 07740
Phone (732) 222-1299

Other identifiers 2

IdentifierTypeStateIssuer
2057957OtherPK
0893633MedicaidNJ

Other names 1

  • Diamonds Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

444 Ocean Blvd N
Long Branch, NJ 07740
Phone (732) 222-1299

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1124125059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 OCEAN BLVD. N.",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "07740",
            "telephone_number": "732-222-1299",
            "fax_number": "732-222-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 OCEAN BLVD. N.",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "07740",
            "telephone_number": "732-222-1299",
            "fax_number": "732-222-7884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOBELLA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "ALMANZA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "OWNER/OFFICER",
        "authorized_official_telephone_number": "732-222-1299",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "28RS00412800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2057957",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0893633",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diamonds Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Branch, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.