Active NPI
Myreen Martin, RPH
- Pharmacist
- Union City, NJ
National Provider Identifier
1336750322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI03756800
- Practice address
- 3333 Park Ave
Union City, NJ 07087-5913 - Phone
- (201) 558-0094
- NPI assigned
- Aug 12, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI03756800 | NJ | Primary |
Addresses
Primary practice location
3333 Park Ave
Union City, NJ 07087-5913
Mailing address
3333 Park Ave
Union City, NJ 07087-5913
Phone (201) 558-0094
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8628807 | Medicaid | NJ |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | rxm.walgreens.com | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI03756800 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597190400000",
"number": "1336750322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 PARK AVE",
"city": "UNION CITY",
"state": "NJ",
"postal_code": "070875913",
"telephone_number": "201-558-0094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 PARK AVE",
"city": "UNION CITY",
"state": "NJ",
"postal_code": "070875913",
"telephone_number": "201-558-0094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "MYREEN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-12",
"last_updated": "2020-08-12",
"certification_date": "2020-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03756800",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8628807",
"state": "NJ"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "rxm.walgreens.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "3333 Park Ave",
"city": "Union City",
"state": "NJ",
"country_code": "US",
"postal_code": "070875913",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Union City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.