Brunswick Square Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00718900 Issued in NJ

Legal business name

BRUNSWICK SQUARE PHARMACY

Practice address

1177 State Route 18
East Brunswick, NJ 08816-4935

Phone

(732) 257-5200

Fax

(732) 257-2600

NPI assigned

May 10, 2012

Organization subpart

No

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

Authorized official

Name

Marian Mikaille

Title

President

Phone

(201) 726-3033

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Brunswick Square Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

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

• Marian B. Mikaile

  • Pharmacist
  • East Brunswick, NJ
  • NPI 1821742669
  NPD

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

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487030400000",
    "number": "1386903391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BEVERLY RD",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088571614",
            "telephone_number": "732-257-5200",
            "fax_number": "732-257-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 STATE ROUTE 18",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088164935",
            "telephone_number": "732-257-5200",
            "fax_number": "732-257-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUNSWICK SQUARE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-10",
        "last_updated": "2017-02-14",
        "status": "A",
        "authorized_official_last_name": "MIKAILLE",
        "authorized_official_first_name": "MARIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-726-3033"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00718900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2135495",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brunswick Square Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Brumer, PT
• Brunswick Dental Group
• Brunswick Family Dental Center
• Brunswick Medical Associates Inc
• Brunswick Medical Associates, LLC
• Brunswick Surgical Ambulatory Center LLP
• Denine D Bruzzo, LCSW
• Pamela Buckalew, APN
• Christopher Buckle, M.D.
• William Bulcroft, PA-C

• Community/Retail Pharmacy in East Brunswick, NJ
• Providers in East Brunswick, 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 Feb 14, 2017; 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.