Active NPI
MLK Pharmacy
- Community/Retail Pharmacy
- Jersey City, NJ
National Provider Identifier
1467516765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 28RS00641000
- Legal business name
- MLK PHARMACY
- Practice address
- 173 Martin Luther King Jr Dr
Jersey City, NJ 07305-3310 - Phone
- (201) 332-7032
- Fax
- (201) 333-0348
- NPI assigned
- Dec 20, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Abdul Bari
- Title
- Owner
- Phone
- (201) 332-7032
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 28RS00641000 | NJ | Primary |
Addresses
Primary practice location
173 Martin Luther King Jr Dr
Jersey City, NJ 07305-3310
Mailing address
173 Martin Luther King Jr Dr
Jersey City, NJ 07305-3310
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0042366 | Medicaid | NJ | |
| 3128659 | Other | OTHER ID NUMBER |
Other names 1
- MLK PHARMACY
National Provider Directory
National Provider Directory- Tax ID family
- Abdul and Borges Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pharmacist
- East Orange, NJ
- NPI 1225193774
Locations
173 Martin Luther King Jr Dr
Jersey City, NJ 07305
Phone (201) 332-7032
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1189641600000",
"number": "1467516765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "173 MARTIN LUTHER KING JR DR",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073053310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "173 MARTIN LUTHER KING JR DR",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073053310",
"telephone_number": "201-332-7032",
"fax_number": "201-333-0348"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MLK PHARMACY",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-20",
"last_updated": "2007-09-13",
"status": "A",
"authorized_official_last_name": "BARI",
"authorized_official_first_name": "ABDUL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "201-332-7032"
},
"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": "28RS00641000",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0042366",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER",
"identifier": "3128659",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MLK PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Jersey City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.