Active NPI
Edward Joseph Vaccaro, R.PH.
- Pharmacist
- Frenchtown, NJ
National Provider Identifier
1255688024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28R101541500
- Practice address
- 10 Wagon Wheel Dr
Frenchtown, NJ 08825-4231 - Phone
- (609) 828-1441
- NPI assigned
- Aug 10, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28R101541500 | NJ | Primary |
Addresses
Primary practice location
10 Wagon Wheel Dr
Frenchtown, NJ 08825-4231
Mailing address
10 Wagon Wheel Dr
Frenchtown, NJ 08825-4231
Phone (609) 828-1441
Other practice location 1
30 Main St
Clinton, NJ 08809-1328
Phone (908) 735-5316
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0189201 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28R101541500 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinton Pharmacy, Inc | Past | Accepting new patients | |
| Maxim Health Systems, LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Clinton, NJ
- NPI 1194837377
-
- Home Health Agency
- Columbia, MD
- NPI 1356455380
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1255688024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 WAGON WHEEL DR",
"city": "FRENCHTOWN",
"state": "NJ",
"postal_code": "088254231",
"telephone_number": "609-828-1441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 WAGON WHEEL DR",
"city": "FRENCHTOWN",
"state": "NJ",
"postal_code": "088254231",
"telephone_number": "609-828-1441"
}
],
"practiceLocations": [
{
"address_1": "30 Main St",
"address_purpose": "LOCATION",
"city": "Clinton",
"state": "NJ",
"postal_code": "088091328",
"country_code": "US",
"telephone_number": "908-735-5316",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VACCARO",
"first_name": "EDWARD",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-10",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28R101541500",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0189201",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Frenchtown, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.