Organization Active NPI

Tesh

Doing business as Clinton Pharmacy & Healthcare Center

  • Community/Retail Pharmacy
  • Newark, NJ
National Provider Identifier
1629116033
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
RS006810 Issued in NJ
Legal business name
TESH
Doing business as
Clinton Pharmacy & Healthcare Center
Practice address
784 Clinton Ave
Newark, NJ 07108-1045
Phone
(973) 375-6003
Fax
(973) 375-4861
NPI assigned
Feb 1, 2007
Last updated
Feb 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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

Authorized official

Name
Mohamed Ehab Solaman, PHARMD, RPH
Title
Pharmacist
Phone
(973) 375-6003

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X RS006810 NJ
Community/Retail Pharmacy 3336C0003X RS006810 NJ Primary

Addresses

Primary practice location

784 Clinton Ave
Newark, NJ 07108-1045

Mailing address

784 Clinton Ave
Newark, NJ 07108-1045
Phone (973) 375-6003

Other identifiers 1

IdentifierTypeStateIssuer
0189219MedicaidNJ

Other names 1

  • Clinton Pharmacy & Healthcare Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930017509 NJ DME Supplier - Pharmacy 2961600085 Practice locations: Newark, NJ
O20120801000380 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 2961600085 Practice locations: Newark, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Tesh784 Clinton Ave, Newark, NJ 07108-1045(973) 375-6003 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jan 23, 2009

National Provider Directory

National Provider Directory

Locations

784 Clinton Ave
Newark, NJ 07108
Phone (973) 375-6003

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456358400000",
    "number": "1629116033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 CLINTON AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071081045",
            "telephone_number": "973-375-6003",
            "fax_number": "973-375-4861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 CLINTON AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071081045",
            "telephone_number": "973-375-6003",
            "fax_number": "973-375-4861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TESH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2016-02-25",
        "status": "A",
        "authorized_official_last_name": "SOLAMAN",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "EHAB",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "973-375-6003",
        "authorized_official_credential": "PHARMD, RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NJ",
            "license": "RS006810",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "RS006810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0189219",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinton Pharmacy & Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.