Organization Active NPI

Carlbert Drugs Inc

Doing business as Buckleys Drug Store

  • Pharmacy
  • Englewood, NJ
National Provider Identifier
1467545897
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
28RS00419300 Issued in NJ
Legal business name
CARLBERT DRUGS INC
Doing business as
Buckleys Drug Store
Practice address
35 E Palisade Ave
Englewood, NJ 07631-2901
Phone
(201) 569-1345
Fax
(201) 568-5354
NPI assigned
Sep 30, 2006
Last updated
Aug 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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

Authorized official

Name
Gilbert Dominguez, RPHNPI 1639187032
Title
Pic
Phone
(201) 569-1365

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 28RS00419300 NJ Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

35 E Palisade Ave
Englewood, NJ 07631-2901

Mailing address

35 E Palisade Ave
Englewood, NJ 07631-2901
Phone (201) 569-1345

Other identifiers 2

IdentifierTypeStateIssuer
4399901MedicaidNJ
3108809OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • BUCKLEYS DRUG STORE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061122000083 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 7618975863 Practice locations: Englewood, NJ
O20101210000373 NJ Part B Supplier - Pharmacy 7618975863 1 other NPI on this enrollment
Practice locations: Englewood, NJ

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Buckleys Drug Store35 E Palisade Ave, Englewood, NJ 07631-2901(201) 816-0802 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Orthoses: Off-The-Shelf|Nebulizer Equipment and/or Supplies|Surgical Dressings|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Accepts assignmentParticipating since Mar 5, 2013

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312329600000",
    "number": "1467545897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 E PALISADE AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312901",
            "telephone_number": "201-569-1345",
            "fax_number": "201-568-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 E PALISADE AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312901",
            "telephone_number": "201-569-1345",
            "fax_number": "201-568-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLBERT DRUGS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-30",
        "last_updated": "2011-08-03",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ",
        "authorized_official_first_name": "GILBERT",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "201-569-1365",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "28RS00419300",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4399901",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3108809",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BUCKLEYS DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.