Bald Eagle Pharmacy LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

28RI02690900 Issued in NJ

Legal business name

BALD EAGLE PHARMACY LLC

Doing business as

Bald Eagle Pharmacy

Practice address

610 Valley Health PLZ
Paramus, NJ 07652

Phone

(201) 225-0970

Fax

(201) 225-0973

NPI assigned

Jul 30, 2006

Last updated

Jun 7, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Anthony Guercio

Title

Manager

Phone

(973) 728-2007

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• BALD EAGLE PHARMACY Doing business as

Locations

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.

• Evelyn Fernandez, RPH

  • Pharmacist
  • West Milford, NJ
  • NPI 1457679078
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528329600000",
    "number": "1154336790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 FRANKLIN ST FL 2",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071091134",
            "telephone_number": "973-728-2007",
            "fax_number": "973-728-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 VALLEY HEALTH PLZ",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "07652",
            "telephone_number": "201-225-0970",
            "fax_number": "201-225-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALD EAGLE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2018-06-07",
        "status": "A",
        "authorized_official_last_name": "GUERCIO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "973-728-2007"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NJ",
            "license": "28RI02690900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3193391",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0093181",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BALD EAGLE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BALD EAGLE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Baklajian, M.D
• Rosine Baklayan
• Balance Lab Doctors of Physical Therapy, LLC
• Balanced Body Chiropractic Healthcare PC (Balanced Body Holistic Healthcare)
• Bald Eagle Drugs Inc (Bald Eagle Pharmacy)
• Anna Baldassari
• Nicole Marina Bancroft, PHYSICIAN ASSISTANT
• Rebecca Bar-Eli
• Nicole Baratta
• Ashley Nicole Bardi, LCSW, LCADC

• Long Term Care Pharmacy in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Long Term Care Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; 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.