NPIMap

Organization Active NPI

Santa Maria Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Perth Amboy, NJ
National Provider Identifier
1396813192
Registry record updated Jul 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00677200 Issued in NJ
Legal business name
SANTA MARIA PHARMACY, INC.
Practice address
432 Hall Ave
Perth Amboy, NJ 08861-2515
Phone
(732) 442-0163
Fax
(732) 442-4256
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2009

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

Authorized official

Name
Dr. Mina Azer, PHARMDNPI 1124390471
Title
President & Pharmacist in Charge
Phone
(732) 251-3971

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 28RS00677200 NJ Primary

Addresses

Primary practice location

432 Hall Ave
Perth Amboy, NJ 08861-2515

Mailing address

432 Hall Ave
Perth Amboy, NJ 08861-2515
Phone (732) 442-0163

Other identifiers 3

IdentifierTypeStateIssuer
3114155OtherOTHER ID NUMBER
4275403MedicaidNJ
3114155OtherOTHER ID NUMBER-COMMERCIAL NUMBER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248220800000",
    "number": "1396813192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 HALL AVE",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088612515",
            "telephone_number": "732-442-0163",
            "fax_number": "732-442-4256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 HALL AVE",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088612515",
            "telephone_number": "732-442-0163",
            "fax_number": "732-442-4256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA MARIA PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2009-07-22",
        "status": "A",
        "authorized_official_last_name": "AZER",
        "authorized_official_first_name": "MINA",
        "authorized_official_title_or_position": "PRESIDENT & PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "732-251-3971",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00677200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "3114155",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4275403",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3114155",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; 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.