Passaic Community Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00592100 Issued in NJ

Legal business name

PASSAIC COMMUNITY PHARMACY INC

Practice address

339 Passaic St
Passaic, NJ 07055-5818

Phone

(973) 471-0160

Fax

(973) 471-0110

NPI assigned

Dec 15, 2006

Organization subpart

No

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

Authorized official

Name

Osama Awad

Title

Officer

Phone

(973) 471-0160

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Passaic Community Pharmacy Inc

  • Pharmacist
  • Passaic, NJ
  • NPI 1205871027

  O20100930080487

  Same enrollment

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329264000000",
    "number": "1326100264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 PASSAIC ST",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555818",
            "telephone_number": "973-471-0160",
            "fax_number": "973-471-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 PASSAIC ST",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555818",
            "telephone_number": "973-471-0160",
            "fax_number": "973-471-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSAIC COMMUNITY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2012-02-15",
        "status": "A",
        "authorized_official_last_name": "AWAD",
        "authorized_official_first_name": "OSAMA",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "973-471-0160"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00592100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8428301",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8428310",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Parks, LCSW, LCADC
• Lorenza Elena Paskas
• Passaic Board of Education
• Passaic Chiropractic & Therapy Center PC
• Passaic Community Pharmacy Inc
• Passaic Community Pharmacy Inc
• Passaic County Integrated Healthcare
• Passaic Dental Association
• Passaic Eyecare, PC
• Passaic Family Chiropractic, PC

• All providers in Passaic, NJ
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.