NPIMap

Organization Active NPI

Hackensack Meridian Ambulatory Care, Inc.

Doing business as Hackensack Meridian Health Pharmacy

  • Community/Retail Pharmacy
  • Eatontown, NJ
National Provider Identifier
1306440078
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
HACKENSACK MERIDIAN AMBULATORY CARE, INC.
Doing business as
Hackensack Meridian Health Pharmacy
Practice address
34 Industrial Way E Ste 4
Eatontown, NJ 07724-3319
Phone
(908) 427-6010
Fax
(908) 427-6099
NPI assigned
Nov 24, 2020
Last updated
Feb 7, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
HMH HOSPITALS CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Authorized official

Name
Dr. Audra Manekas, PHARMD
Title
Director
Phone
(908) 427-6010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

34 Industrial Way E Ste 4
Eatontown, NJ 07724-3319

Mailing address

34 Industrial Way E Ste 4
Eatontown, NJ 07724-3319
Phone (908) 427-6010

Other identifiers 1

IdentifierTypeStateIssuer
28RS00781300OtherNJPHARMACY LICENSE

Other names 1

  • Hackensack Meridian Health Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210701003154 NJ DME Supplier - Pharmacy 8527978774 Practice locations: Eatontown, NJ

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Meridian Home Care SVC Inc25 organizations share this tax ID, including this one
Part of
George B Jacobs MD

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

34 Industrial Way E
Ste 4
Eatontown, NJ 07724
Phone (908) 427-6000

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Visiting Health Services of New JerseyWoodland Park, NJ, CCN 317058 Home health agency 5% Or Greater Direct Ownership Interest (50%)
Operational/Managerial Control		 May 1, 2017
May 1, 2017
VHS Hospice Services of New JerseyWoodland Park, NJ, CCN 311508 Hospice 5% Or Greater Direct Ownership Interest (50%) May 1, 2017

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Vhsnj at Home, LLC

    dba VHS Hospice Services of New Jersey

    • Community Based Hospice Care Agency
    • Woodland Park, NJ
    • NPI 1174063200

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • Vhsnj at Home, LLC

    dba Visiting Health Services of New Jersey

    • Home Health Agency
    • Woodland Park, NJ
    • NPI 1518407642

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1606176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644192000000",
    "number": "1306440078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 INDUSTRIAL WAY E STE 4",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077243319",
            "telephone_number": "908-427-6010",
            "fax_number": "908-427-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 INDUSTRIAL WAY E STE 4",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077243319",
            "telephone_number": "908-427-6010",
            "fax_number": "908-427-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACKENSACK MERIDIAN AMBULATORY CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HMH HOSPITALS CORPORATION",
        "enumeration_date": "2020-11-24",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A",
        "authorized_official_last_name": "MANEKAS",
        "authorized_official_first_name": "AUDRA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "908-427-6010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "28RS00781300",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hackensack Meridian Health Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hackensack Meridian Health Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eatontown, NJ

Sources for this page

Verify at the official NPI Registry.