NPIMap

Organization Active NPI

Cardinal Health 132, LLC

Doing business as CompleteCare Community Pharmacy

  • Community/Retail Pharmacy
  • Vineland, NJ
National Provider Identifier
1558719252
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00748900 Issued in NJ
Legal business name
CARDINAL HEALTH 132, LLC
Doing business as
CompleteCare Community Pharmacy
Practice address
785 W Sherman Ave Ste 100
Vineland, NJ 08360-6913
Phone
(856) 696-1861
Fax
(614) 553-5915
NPI assigned
Jun 3, 2016
Last updated
Sep 6, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CARDINAL HEALTH 132, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Authorized official

Name
Michael Brown
Title
Vice President, Managed Services
Phone
(281) 749-4764

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 28RS00748900 NJ Primary

Addresses

Primary practice location

785 W Sherman Ave Ste 100
Vineland, NJ 08360-6913

Mailing address

Attn: CHC Retail Pharmacy Dept. 13651 Dublin CT
Stafford, TX 77477-4317
Phone (281) 749-4000

Other identifiers 1

IdentifierTypeStateIssuer
2160359OtherPK

Other names 1

  • CompleteCare Community Pharmacy Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160921000600 NJ Part B Supplier - Pharmacy 4688961501 Practice locations: Vineland, NJ
O20171109002735 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 4688961501 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Passaic, NJ; Vineland, NJ; West New York, NJ

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Cardinal Health 132 LLC11 organizations share this tax ID, including this one
Part of
Cardinal Health 132 LLC

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

785 W Sherman Ave
Ste 100
Vineland, NJ 08360
Phone (856) 696-1861

13651 Dublin Ct
Fl 2
Stafford, TX 77477
Phone (281) 749-4245

NPI Registry JSON

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662422400000",
    "number": "1558719252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ATTN: CHC RETAIL PHARMACY DEPT. 13651 DUBLIN CT",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774774317",
            "telephone_number": "281-749-4000",
            "fax_number": "614-652-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 W SHERMAN AVE STE 100",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606913",
            "telephone_number": "856-696-1861",
            "fax_number": "614-553-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDINAL HEALTH 132, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARDINAL HEALTH 132, LLC",
        "enumeration_date": "2016-06-03",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-02",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT, MANAGED SERVICES",
        "authorized_official_telephone_number": "281-749-4764"
    },
    "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": "28RS00748900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2160359",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CompleteCare Community Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CompleteCare Community Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vineland, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.