Organization Active NPI

Saint Mary and Jessie LLC

Doing business as Advanced Pharmacy

  • Community/Retail Pharmacy
  • Perth Amboy, NJ
National Provider Identifier
1245245869
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00645500 Issued in NJ
Legal business name
SAINT MARY AND JESSIE LLC
Doing business as
Advanced Pharmacy
Practice address
288 Smith St
Perth Amboy, NJ 08861-4042
Phone
(732) 324-4490
Fax
(732) 324-4491
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Authorized official

Name
Ashraf DawodNPI 1346517257
Title
Owner
Phone
(732) 324-4490

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 28RS00645500 NJ Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

288 Smith St
Perth Amboy, NJ 08861-4042

Mailing address

288 Smith St
Perth Amboy, NJ 08861-4042
Phone (732) 324-4490

Other identifiers 2

IdentifierTypeStateIssuer
2055524OtherPK
0061999MedicaidNJ

Other names 1

  • ADVANCED PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930098534 NJ DME Supplier - Pharmacy 9830309285 Practice locations: Perth Amboy, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Saint Mary and Jessie LLC288 Smith St, Perth Amboy, NJ 08861-4042(732) 324-4490 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Nov 1, 2023

National Provider Directory

National Provider Directory

Locations

288 Smith St
Perth Amboy, NJ 08861
Phone (732) 324-4490

Practitioners & affiliated clinicians

Practitioners 4

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": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469664000000",
    "number": "1245245869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 SMITH ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088614042",
            "telephone_number": "732-324-4490",
            "fax_number": "732-324-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 SMITH ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088614042",
            "telephone_number": "732-324-4490",
            "fax_number": "732-324-4491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT MARY AND JESSIE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2016-07-28",
        "status": "A",
        "authorized_official_last_name": "DAWOD",
        "authorized_official_first_name": "ASHRAF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-324-4490"
    },
    "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": "28RS00645500",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2055524",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0061999",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVANCED PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Perth Amboy, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.