Hudacko's Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00219000 Issued in NJ

Legal business name

HUDACKO'S PHARMACY INC

Practice address

861 Broadway
Bayonne, NJ 07002-3031

Phone

(201) 436-4488

Fax

(201) 436-0240

NPI assigned

Sep 15, 2006

Organization subpart

No

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

Authorized official

Name

Brian HostNPI 1700534146

Title

Owner

Phone

(201) 436-4488

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 3

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

• Brian Host, PHARMD

  • Pharmacist
  • Bayonne, NJ
  • NPI 1700534146
  NPD Authorized official
• Peter Halecky

  • Pharmacist
  • Bayonne, NJ
  • NPI 1609524040
  NPD
• Gwen Pineiro

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Bayonne, NJ
  • NPI 1356099576
  NPD (past)

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1316043573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023031",
            "telephone_number": "201-436-4488",
            "fax_number": "201-436-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023031",
            "telephone_number": "201-436-4488",
            "fax_number": "201-436-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUDACKO'S PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "HOST",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-436-4488"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NJ",
            "license": "28RS00219000",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00219000",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NJ",
            "license": "28RS00219000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0033774",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP NUMBER",
            "identifier": "3104293",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4251105",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0328243",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Othniel Houston
• Tigran Hovhannisyan, DMD
• Paul A Hriso, MD PA
• Joseph Hromy
• Karen Huang, DO
• Hudacko's Pharmacy Inc
• Hudson Cares Therapy & in Community Services LLC
• Hudson Center for Digestive Health LLC
• Hudson County Internal Medicine, PC
• Hudson County Orthodontics LLC

• Community/Retail Pharmacy in Bayonne, NJ
• Providers in Bayonne, 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 Dec 19, 2023; 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.