Obeng Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

OBENG PHARMACY LLC

Doing business as

obeng pharmacy llc

Practice address

95 Broadway
Newark, NJ 07104-3875

Phone

(215) 459-8390

Fax

(862) 237-7603

NPI assigned

Sep 29, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

OBENG PHARMACY LLCAs reported in NPPES

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

Authorized official

Name

Mr. Adje Daby Koffi, RPHNPI 1619375995

Title

Ceo

Phone

(215) 459-8390

Specialties & licenses 1

Addresses

Other names 1

• obeng pharmacy llc Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Obeng Pharmacy LLC

  dba Obeng Pharmacy

  • Community/Retail Pharmacy
  • Newark, NJ
  • NPI 1538557178

  O20150121001898

  Same enrollment

Tax ID family

Obeng Pharmacy LLC2 organizations share this tax ID, including this one

Part of

Obeng Pharmacy LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Obeng Pharmacy LLC

  • Community/Retail Pharmacy
  • Newark, NJ
  • NPI 1891347225
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Adje Daby Koffi

  • Pharmacist
  • Newark, NJ
  • NPI 1619375995
  NPD (past) Authorized official

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1376052670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 DR MARTIN LUTHER KING JR BLVD",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021186",
            "telephone_number": "215-459-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 BROADWAY",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071043875",
            "telephone_number": "215-459-8390",
            "fax_number": "862-237-7603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "671 Dr Martin Luther King Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071021186",
            "country_code": "US",
            "telephone_number": "215-459-8390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OBENG PHARMACY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OBENG PHARMACY LLC",
        "enumeration_date": "2017-09-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KOFFI",
        "authorized_official_first_name": "ADJE",
        "authorized_official_middle_name": "DABY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-459-8390",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "obeng pharmacy llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Ann O'Shaughnessy, RN, APN, AGACNP-BC
• James Timothy O'Shea, M.D.
• Peter John Oates, NP-C
• Anuoluwapo Obasa
• Chinenye Obeleagu
• Obeng Pharmacy LLC (Obeng Pharmacy)
• Obeng Pharmacy LLC
• Emmanuel Obeng, BSN RN
• Edna Obietiala
• Nosike Chinua Obionwu, MD

• Community/Retail Pharmacy in Newark, NJ
• Providers in Newark, 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 Jul 21, 2022; 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.