Chancellor Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00714200 Issued in NJ

Legal business name

CHANCELLOR PHARMACY

Doing business as

chancellor pharmacy

Practice address

894 Chancellor Ave
Irvington, NJ 07111-1214

Phone

(973) 399-2700

Fax

(973) 399-2701

NPI assigned

Sep 9, 2011

Last updated

Apr 17, 2017By 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

Rinaben Patel

Title

President/Pharmacy Supervisor

Phone

(973) 399-2700

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• chancellor pharmacy Doing business as

Locations

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1174805774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "894 CHANCELLOR AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071111214",
            "telephone_number": "973-399-2700",
            "fax_number": "973-399-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "894 CHANCELLOR AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071111214",
            "telephone_number": "973-399-2700",
            "fax_number": "973-399-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANCELLOR PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-09",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "RINABEN",
        "authorized_official_title_or_position": "PRESIDENT/PHARMACY SUPERVISOR",
        "authorized_official_telephone_number": "973-399-2700"
    },
    "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": "28RS00714200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0290017",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2131872",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "chancellor pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; 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.