South Broad Drugs Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00358500 Issued in NJ

Legal business name

SOUTH BROAD DRUGS INC

Doing business as

SOUTH BROAD DRUGS

Practice address

1094 Broad St
Newark, NJ 07114-2004

Phone

(973) 824-3929

Fax

(973) 824-9446

NPI assigned

Jul 22, 2006

Organization subpart

No

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

Authorized official

Name

Vinodrai Shah, RPH

Title

Supervising RPH

Phone

(973) 824-3929

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• SOUTH BROAD DRUGS Doing business as

Locations

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303257600000",
    "number": "1528089596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1094 BROAD ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071142004",
            "telephone_number": "973-824-3929",
            "fax_number": "973-824-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1094 BROAD ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071142004",
            "telephone_number": "973-824-3929",
            "fax_number": "973-824-9446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BROAD DRUGS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2011-04-20",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "VINODRAI",
        "authorized_official_title_or_position": "SUPERVISING RPH",
        "authorized_official_telephone_number": "973-824-3929",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00358500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3126528",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4358007",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH BROAD DRUGS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nizar Souayah, M.D.
• Sean A Souels, PSYD
• Soul Catering LLC
• Natalie Ann Sous, MD
• Jessica Sousa, MSW
• Theodore J Southgate, MD
• Sovereign Health of New Jersey
• Shaista Sowell
• Anthony Spadaro, MD
• Antonio Jose Maria Spagnolo Allende, MD, MPH

• Community/Retail Pharmacy in Newark, NJ
• Providers in Newark, 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 Apr 20, 2011; 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.