Organization Active NPI

GSP Pharmacy Inc

  • Community/Retail Pharmacy
  • East Orange, NJ
National Provider Identifier
1225074776
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00653400 Issued in NJ
Legal business name
GSP PHARMACY INC
Practice address
90 Washington St
East Orange, NJ 07017-1050
Phone
(973) 676-0800
Fax
(973) 676-1408
NPI assigned
Jun 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

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

Authorized official

Name
Pinal Patel, RPH
Title
Pharmasit
Phone
(973) 676-0800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 28RS00653400 NJ Primary

Addresses

Primary practice location

90 Washington St
East Orange, NJ 07017-1050

Mailing address

90 Washington St
East Orange, NJ 07017-1050
Phone (973) 676-0800

Other identifiers 2

IdentifierTypeStateIssuer
0082678MedicaidNJ
2055658OtherPK

Other names 1

  • WASHINGTON SHOP PHARMACY Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930084730 NJ DME Supplier - Pharmacy 0648471508 Practice locations: East Orange, NJ
O20120730000023 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 0648471508 Practice locations: East Orange, NJ

National Provider Directory

National Provider Directory
Tax ID family
GSP Pharmacy Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

90 Washington St
East Orange, NJ 07017
Phone (973) 304-5180

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455062400000",
    "number": "1225074776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 WASHINGTON ST",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070171050",
            "telephone_number": "973-676-0800",
            "fax_number": "973-676-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 WASHINGTON ST",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070171050",
            "telephone_number": "973-676-0800",
            "fax_number": "973-676-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GSP PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2016-02-10",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "PINAL",
        "authorized_official_title_or_position": "PHARMASIT",
        "authorized_official_telephone_number": "973-676-0800",
        "authorized_official_credential": "RPH"
    },
    "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": "28RS00653400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0082678",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2055658",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WASHINGTON SHOP PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.