Gold Kimball International, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00622500 Issued in NJ

Legal business name

GOLD KIMBALL INTERNATIONAL, INC.

Practice address

2080 W County Line Rd
Jackson, NJ 08527-2015

Phone

(732) 367-0688

NPI assigned

Jan 6, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Chaoying Chen, R.PH.

Title

President

Phone

(732) 367-0688

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1168041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316095573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 W COUNTY LINE RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272015",
            "telephone_number": "732-367-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 W COUNTY LINE RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272015",
            "telephone_number": "732-367-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD KIMBALL INTERNATIONAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "CHAOYING",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-367-0688",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00622500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9062009",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9062017",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "3145174",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rena B Glassman, BCBA
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• Chloe A Goldfarb
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• Community/Retail Pharmacy in Jackson, NJ
• Providers in Jackson, 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 Aug 22, 2020; 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.