Fresh Emporium Food Market, Corp

Primary specialty

PharmacyTaxonomy code 333600000X

License

28RS00753600 Issued in NJ

Legal business name

FRESH EMPORIUM FOOD MARKET, CORP

Doing business as

Fresh Imperium Pharmacy Jefferson

Practice address

757 State Route 15 S
Lake Hopatcong, NJ 07849-2284

Phone

(862) 803-9027

NPI assigned

Jan 17, 2017

Organization subpart

No

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

Authorized official

Name

Paul Granger

Title

Director of Pharmacy

Phone

(717) 324-4924

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Fresh Imperium Pharmacy Jefferson Doing business as

Locations

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484611200000",
    "number": "1407392343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 STATE ROUTE 15 S",
            "city": "LAKE HOPATCONG",
            "state": "NJ",
            "postal_code": "078492284",
            "telephone_number": "862-803-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 STATE ROUTE 15 S",
            "city": "LAKE HOPATCONG",
            "state": "NJ",
            "postal_code": "078492284",
            "telephone_number": "862-803-9027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH EMPORIUM FOOD MARKET, CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-17",
        "last_updated": "2017-01-17",
        "status": "A",
        "authorized_official_last_name": "GRANGER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "717-324-4924"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "28RS00753600",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167102",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fresh Imperium Pharmacy Jefferson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Lake Hopatcong, NJ
• Providers in Lake Hopatcong, 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 17, 2017; 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.