Active NPI
GSP Pharmacy Inc
- Community/Retail Pharmacy
- East Orange, NJ
National Provider Identifier
1225074776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 28RS00653400
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0082678 | Medicaid | NJ | |
| 2055658 | Other | PK |
Other names 1
- WASHINGTON SHOP PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- East Orange, NJ
- NPI 1083193973
-
- Durable Medical Equipment & Medical Supplies
- East Orange, NJ
- NPI 1639698517
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.