Active NPI
Acme Markets Inc
Doing business as Acme Pharmacy #1054
- Community/Retail Pharmacy
- Midland Park, NJ
National Provider Identifier
1558738849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 28RS00549300
- Legal business name
- ACME MARKETS INC
- Doing business as
- Acme Pharmacy #1054
- Practice address
- 136 Lake Ave
Midland Park, NJ 07432 - Phone
- (201) 493-7055
- Fax
- (201) 493-7058
- NPI assigned
- Aug 21, 2015
- Last updated
- Jul 24, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tiffany Eliopulos
- Title
- Assistant Manager, Enrollments
- Phone
- (208) 395-3906
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Pharmacy | 333600000X | NU | ||
| Community/Retail Pharmacy | 3336C0003X | 28RS00549300 | NJ | Primary |
Addresses
Primary practice location
136 Lake Ave
Midland Park, NJ 07432
Mailing address
250 E Parkcenter Blvd
Mailstop Sec2-B
Boise, ID 83706-3940
Phone (208) 395-3920
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0517593 | Medicaid | NJ | |
| 2154236 | Other | PK |
Other names 1
- ACME PHARMACY #1054
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160216000310 | NJ | DME Supplier - Pharmacy | 4082674940 | Practice locations: Midland Park, NJ |
National Provider Directory
National Provider Directory- Tax ID family
- Acme Markets Inc
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
Member of 2
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Sav-On Pharmacy #3174
- Community/Retail Pharmacy
- Ammon, ID
- NPI 1922055383
Member Of
-
dba Safeway Phamracy #4837
- Community/Retail Pharmacy
- District Heights, MD
- NPI 1588600191
Member Of
Locations
136 Lake Ave
Midland Park, NJ 07432
Phone (201) 493-7055
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440115200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1532390400000",
"number": "1558738849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 E PARKCENTER BLVD",
"address_2": "MAILSTOP SEC2-B",
"city": "BOISE",
"state": "ID",
"postal_code": "837063940",
"telephone_number": "208-395-3920",
"fax_number": "623-282-3834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 LAKE AVE",
"city": "MIDLAND PARK",
"state": "NJ",
"postal_code": "07432",
"telephone_number": "201-493-7055",
"fax_number": "201-493-7058"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ACME MARKETS INC",
"organizational_subpart": "NO",
"enumeration_date": "2015-08-21",
"last_updated": "2018-07-24",
"status": "A",
"authorized_official_last_name": "ELIOPULOS",
"authorized_official_first_name": "TIFFANY",
"authorized_official_title_or_position": "ASSISTANT MANAGER, ENROLLMENTS",
"authorized_official_telephone_number": "208-395-3906"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NJ",
"license": "28RS00549300",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0517593",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2154236",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ACME PHARMACY #1054",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Midland Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.