Jre Ave Maria LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

JRE AVE MARIA LLC

Doing business as

Randolph Pharmacy

Practice address

124 Route 10
Unit 4
Randolph, NJ 07869-2415

Phone

(973) 442-4020

NPI assigned

Jan 9, 2017

Organization subpart

Yes

Parent organization

JRE AVE MARIA LLCAs reported in NPPES

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

Authorized official

Name

John GhalyNPI 1699276915

Title

Managing Member

Phone

(973) 442-4020

Specialties & licenses 1

Addresses

Other names 1

• Randolph Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Part of

Jre Ave Maria LLC

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Ghaly, RPH

  • Pharmacist
  • Randolph, NJ
  • NPI 1699276915
  NPD Authorized official

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579824000000",
    "number": "1376089706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 ROUTE 10",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692415",
            "telephone_number": "973-442-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 ROUTE 10",
            "address_2": "UNIT 4",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692415",
            "telephone_number": "973-442-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JRE AVE MARIA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JRE AVE MARIA LLC",
        "enumeration_date": "2017-01-09",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A",
        "authorized_official_last_name": "GHALY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "973-442-4020"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Randolph Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Randolph Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia Johnsen, LCSW
• Ashley Lynn Johnson
• Julie Kathleen Jones, DVM
• Yvanne Josaphat, MSN, APRN, FNP-C
• Lisa Vettemvely Joseph, MD
• K Simms Physical Therapy
• Ian Howard Kaden, M.D.
• Efthimios H Kalavrouziotis, D.M.D.
• Christine Ursula Kapinos, RPH
• George Peter Kaplan, DMD

• Pharmacy in Randolph, NJ
• Providers in Randolph, NJ by specialty
• Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.