Penn Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PENN PHARMACY LLC

Doing business as

Penn Pharmacy

Practice address

95 Ferry St
Newark, NJ 07105-1816

Phone

(973) 732-9180

Fax

(973) 732-9181

NPI assigned

Mar 14, 2021

Organization subpart

No

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

Authorized official

Name

Esmael Abdelhadi

Title

Owner

Phone

(973) 732-9180

Specialties & licenses 1

Addresses

Other names 1

• Penn Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

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

{
    "created_epoch": "1615680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1437734134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 FERRY ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071051816",
            "telephone_number": "973-732-9181",
            "fax_number": "973-732-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 FERRY ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071051816",
            "telephone_number": "973-732-9180",
            "fax_number": "973-732-9181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-14",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "ABDELHADI",
        "authorized_official_first_name": "ESMAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-732-9180"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penn Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Penn Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Velma Opal Pemberton, APN
• Edwin Antonio Pena, MD
• Evelyn Pena, RD
• Rafael A Pena Jr., LCADC
• Valerie Peng
• Penn RX Pharmacy Inc.
• Lori A Pennell, ANP
• Matthew Aaron Penner, DDS
• People Access Unlimited.Org
• People Services

• Community/Retail Pharmacy in Newark, NJ
• Providers in Newark, 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 Dec 15, 2021; 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.