Organization Active NPI

Farmacias del Pueblo LLC

  • Community/Retail Pharmacy
  • Paterson, NJ
National Provider Identifier
1568567428
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00596200 Issued in NJ
Legal business name
FARMACIAS DEL PUEBLO LLC
Doing business as
Farmacias del Pueblo LLC
Practice address
992-994 Madison Ave
Paterson, NJ 07501
Phone
(973) 523-0500
Fax
(973) 523-1988
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Authorized official

Name
Ramon Tantalean, RPHNPI 1801163951
Title
Corporate Officer
Phone
(973) 523-0500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 28RS00596200 NJ Primary

Addresses

Primary practice location

992-994 Madison Ave
Paterson, NJ 07501

Mailing address

992-994 Madison Ave
Paterson, NJ 07501
Phone (973) 523-0500

Other identifiers 2

IdentifierTypeStateIssuer
2054813OtherPK
8509204MedicaidNJ

Other names 1

  • FARMACIAS DEL PUEBLO LLC Doing business as

National Provider Directory

National Provider Directory

Locations

994 Madison Ave
Paterson, NJ 07501
Phone (973) 523-0500

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482278400000",
    "number": "1568567428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "992-994 MADISON AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "07501",
            "telephone_number": "973-523-0500",
            "fax_number": "973-523-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "992-994 MADISON AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "07501",
            "telephone_number": "973-523-0500",
            "fax_number": "973-523-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARMACIAS DEL PUEBLO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2016-12-21",
        "status": "A",
        "authorized_official_last_name": "TANTALEAN",
        "authorized_official_first_name": "RAMON",
        "authorized_official_title_or_position": "CORPORATE OFFICER",
        "authorized_official_telephone_number": "973-523-0500",
        "authorized_official_credential": "RPH"
    },
    "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": "28RS00596200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2054813",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8509204",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FARMACIAS DEL PUEBLO LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.