Individual provider Active NPI

Marlene Kovac, RPH

  • Pharmacist
  • Woodbury, NJ
National Provider Identifier
1326430372
Registry record updated Feb 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI02106700 Issued in NJ
Practice address
509 N Broad St
Woodbury, NJ 08096-1617
Phone
(856) 845-0100
NPI assigned
Feb 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI02106700 NJ Primary
Pharmacist 183500000X 0202009386 VA

Addresses

Primary practice location

509 N Broad St
Woodbury, NJ 08096-1617

Mailing address

509 N Broad St
Woodbury, NJ 08096-1617
Phone (856) 845-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI02106700NJMDPharmacist
0202009386VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1425081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425081600000",
    "number": "1326430372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 N BROAD ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961617",
            "telephone_number": "856-845-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N BROAD ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961617",
            "telephone_number": "856-845-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVAC",
        "first_name": "MARLENE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-28",
        "last_updated": "2015-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02106700",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202009386",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2015; 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.