Balaji Drugs Incorporated
Organization Active NPI Community/Retail Pharmacy · Spring Lake, NJ
NPI 1477589703 · NPPES record last updated Dec 1, 2016
Key facts
- NPI
- 1477589703
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 28RS00666800 (NJ)
- Legal business name
- BALAJI DRUGS INCORPORATED
- Practice address
- 1206 3Rd Ave
Spring Lake, NJ 07762-1331 - Phone
- (732) 449-6157
- Fax
- (732) 449-1349
- NPI assigned
- Jun 26, 2006
- Organization subpart
- No
Authorized official
- Name
- Kalyan Dandu, PHARM D RPH
- Title
- Pharmacist in Charge
- Phone
- (732) 491-3367
Corporate family (same tax ID) 1
Practitioners 1
-
Kalyan Dandu, PHARM. D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930006893 | NJ | DME Supplier - Pharmacy | 9638373178 | Practice locations: Spring Lake, NJ |
| O20120807000676 | NJ | Part B Supplier - Mass Immunization (Roster Biller Only) | 9638373178 | Practice locations: Spring Lake, NJ |
National Provider Directory
- Tax ID family
- Balaji Drugs Incorporated
Locations
1206 3rd Ave
Spring Lake, NJ 07762
Phone (732) 449-6157
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 28RS00666800 | NJ | Yes |
Addresses
Primary practice location
1206 3Rd Ave
Spring Lake, NJ 07762-1331
Mailing address
1206 3Rd Ave
Spring Lake, NJ 07762-1331
Phone (732) 449-6157
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0126951 | Medicaid | NJ | |
| 2056507 | Other | PK |
Other names
- MAIN PHARMACY
Other providers in Spring Lake, NJ
- Anna M Hudak, MSW LCSW
- Ileana Antoniadis
- Assisted Living of Wall Township, LLC
- Atlantic Shore Chiropractic LLC
- Balaji Drugs Incorporated
- Lisa M Baldini
- Gabrielle Ann Bereski
- Lorieta H Bogdan
- Maya Brady
- Brian Brateris
All providers in Spring Lake, NJ · Community/Retail Pharmacy in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.