NPIMap

Organization Active NPI

Cardinal Health 132, LLC

Doing business as North Hudson Pharmacy at Passaic

  • Community/Retail Pharmacy
  • Passaic, NJ
National Provider Identifier
1417460601
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00758600 Issued in NJ
Legal business name
CARDINAL HEALTH 132, LLC
Doing business as
North Hudson Pharmacy at Passaic
Practice address
220 Passaic St
Suite 125-a
Passaic, NJ 07055-6400
Phone
(862) 295-3875
Fax
(973) 458-8033
NPI assigned
Nov 9, 2017
Last updated
Sep 19, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CARDINAL HEALTH 132, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Authorized official

Name
Michael Brown
Title
Vice President, Managed Services
Phone
(281) 749-4764

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 28RS00758600 NJ Primary

Addresses

Primary practice location

220 Passaic St
Suite 125-a
Passaic, NJ 07055-6400

Mailing address

13651 Dublin CT
Stafford, TX 77477-4317
Phone (281) 749-4000

Other identifiers 1

IdentifierTypeStateIssuer
2173146OtherPK

Other names 1

  • North Hudson Pharmacy at Passaic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171109002735 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 4688961501 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Passaic, NJ; Vineland, NJ; West New York, NJ

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Cardinal Health 132 LLC11 organizations share this tax ID, including this one
Part of
Cardinal Health 132 LLC

Other organizations with this tax ID 10

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

220 Passaic St
Ste 125A
Passaic, NJ 07055
Phone (862) 295-3875

13651 Dublin Ct
Stafford, TX 77477
Phone (281) 969-2300

NPI Registry JSON

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1417460601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13651 DUBLIN CT",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774774317",
            "telephone_number": "281-749-4000",
            "fax_number": "614-652-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 PASSAIC ST",
            "address_2": "SUITE 125-A",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070556400",
            "telephone_number": "862-295-3875",
            "fax_number": "973-458-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDINAL HEALTH 132, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARDINAL HEALTH 132, LLC",
        "enumeration_date": "2017-11-09",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-14",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT, MANAGED SERVICES",
        "authorized_official_telephone_number": "281-749-4764"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00758600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2173146",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Hudson Pharmacy at Passaic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Hudson Pharmacy at Passaic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Passaic, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.