Organization Active NPI

Grove Pharmacy Limited Liability Company

  • Community/Retail Pharmacy
  • Montclair, NJ
National Provider Identifier
1245248087
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00723700 Issued in NJ
Legal business name
GROVE PHARMACY LIMITED LIABILITY COMPANY
Doing business as
Grove Pharmacy
Practice address
123 Grove St
Montclair, NJ 07042-4021
Phone
(973) 744-5550
Fax
(973) 744-1340
NPI assigned
Aug 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Authorized official

Name
Rikit Patel
Title
Managing Member
Phone
(973) 744-5550

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 28RS00723700 NJ Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

123 Grove St
Montclair, NJ 07042-4021

Mailing address

123 Grove St
Montclair, NJ 07042-4021
Phone (973) 744-5550

Other identifiers 2

IdentifierTypeStateIssuer
0375195MedicaidNJ
2138725OtherPK

Other names 1

  • Grove Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130712000225 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 4284889841 Practice locations: Montclair, NJ

National Provider Directory

National Provider Directory

Locations

123 Grove St
Montclair, NJ 07042
Phone (973) 744-0030

Practitioners & affiliated clinicians

Practitioners 1

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": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1245248087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 GROVE ST",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424021",
            "telephone_number": "973-744-5550",
            "fax_number": "973-744-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 GROVE ST",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424021",
            "telephone_number": "973-744-5550",
            "fax_number": "973-744-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROVE PHARMACY LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "RIKIT",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "973-744-5550"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00723700",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0375195",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2138725",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grove Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grove Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.