Shree Ganesh Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00734000 Issued in NJ

Legal business name

SHREE GANESH PHARMACY LLC

Practice address

625 Main Ave
Passaic, NJ 07055-4952

Phone

(973) 471-9100

Fax

(973) 471-9900

NPI assigned

Jul 2, 2014

Organization subpart

No

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

Authorized official

Name

Jigna Patel

Title

Member

Phone

(979) 471-9100

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Pharmacy 1st and Sugrical Supplies Doing business as

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1487060109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 MAIN AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070554952",
            "telephone_number": "973-471-9100",
            "fax_number": "973-471-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 MAIN AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070554952",
            "telephone_number": "973-471-9100",
            "fax_number": "973-471-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHREE GANESH PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-02",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "JIGNA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "979-471-9100"
    },
    "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": "28RS00734000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0482072",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2144574",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pharmacy 1st and Sugrical Supplies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Passaic, NJ
• Providers in Passaic, 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 Feb 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.