Active NPI
State Street Pharmacy
- Community/Retail Pharmacy
- Camden, NJ
National Provider Identifier
1295878932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- RS02998
- Legal business name
- STATE STREET PHARMACY
- Practice address
- 735 State St
Camden, NJ 08102-1827 - Phone
- (856) 541-3450
- Fax
- (856) 541-3452
- NPI assigned
- Feb 14, 2007
- Last updated
- Mar 7, 2023
- 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
- Mr. Craig E Lehrman, RPH
- Title
- Vice President
- Phone
- (215) 927-6700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | RS02998 | NJ | Primary |
Addresses
Primary practice location
735 State St
Camden, NJ 08102-1827
Mailing address
PO Box 428
Collingswood, NJ 08108-0428
Phone (856) 858-9292
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4328205 | Medicaid | NJ | |
| 3124625 | Other | NJ | NCPDP |
| RS02998 | Other | NJ | STATE LICENSE |
National Provider Directory
National Provider Directory- Tax ID family
- R D Pharmacy-Westfiel
Other organizations with this tax ID 5
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Gloucester City, NJ
- NPI 1508909227
-
- Community/Retail Pharmacy
- Collingswood, NJ
- NPI 1043432446
-
dba Towne Pharmacy
- Community/Retail Pharmacy
- Merchantville, NJ
- NPI 1053322578
Locations
735 State St
Camden, NJ 08102
Phone (856) 541-3450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678147200000",
"number": "1295878932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 428",
"city": "COLLINGSWOOD",
"state": "NJ",
"postal_code": "081080428",
"telephone_number": "856-858-9292",
"fax_number": "856-858-7286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "735 STATE ST",
"city": "CAMDEN",
"state": "NJ",
"postal_code": "081021827",
"telephone_number": "856-541-3450",
"fax_number": "856-541-3452"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STATE STREET PHARMACY",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-14",
"last_updated": "2023-03-07",
"status": "A",
"authorized_official_last_name": "LEHRMAN",
"authorized_official_first_name": "CRAIG",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "215-927-6700",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NJ",
"license": "RS02998",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4328205",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "3124625",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "RS02998",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Camden, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.