J&J State Street Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00688900 Issued in NJ

Legal business name

J&J STATE STREET PHARMACY INC

Practice address

298 State St
Hackensack, NJ 07601-5515

Phone

(201) 820-3360

NPI assigned

Apr 2, 2009

Organization subpart

No

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

Authorized official

Name

James Demicco

Title

Pharmacist in Charge

Phone

(201) 981-1144

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• J&J State Street Pharmacy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Fedida, R.PH., M.S.

  • Pharmacist
  • Teaneck, NJ
  • NPI 1699090969
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1238630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288137600000",
    "number": "1306088455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 STATE ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076015515",
            "telephone_number": "201-820-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 STATE ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076015515",
            "telephone_number": "201-820-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J&J STATE STREET PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-02",
        "last_updated": "2010-10-27",
        "status": "A",
        "authorized_official_last_name": "DEMICCO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "201-981-1144"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00688900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0207993",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3195674",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "J&J State Street Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Saad Nazmunnoor Islam
• Isnr Pharmacy LLC
• Ivelise Velez Corporation
• Rebeca Raquel Iztueta, APN
• J. Martin Perez, MD, LLC
• Joy Jable, SPEECH THERAPIST
• Michele Jackson Newman, N.P.
• Dina Stamler Jackson, D.M.D.
• Edward Michael Jackson, DMD
• Roxann Jackson, LPN

• Community/Retail Pharmacy in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.