Jill Pharmacy Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00487300 Issued in NJ

Legal business name

JILL PHARMACY CORP

Practice address

191 Rock Rd
Glen Rock, NJ 07452-1706

Phone

(201) 444-4190

Fax

(201) 444-2698

NPI assigned

Jun 21, 2016

Organization subpart

No

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

Authorized official

Name

Harsha Mori

Title

President

Phone

(201) 444-4190

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ROCK RIDGE PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ3 enrollments

Enrollment records 3

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466726400000",
    "number": "1518317593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 ROCK RD",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074521706",
            "telephone_number": "201-444-4190",
            "fax_number": "201-444-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 ROCK RD",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074521706",
            "telephone_number": "201-444-4190",
            "fax_number": "201-444-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILL PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-21",
        "last_updated": "2016-06-24",
        "status": "A",
        "authorized_official_last_name": "MORI",
        "authorized_official_first_name": "HARSHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-444-4190"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00487300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2160724",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROCK RIDGE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Glen Rock, NJ
• Providers in Glen Rock, 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 Jun 24, 2016; 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.