Passaic Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00414400 Issued in NJ

Legal business name

PASSAIC PHARMACY INC

Practice address

291 Monroe St
Passaic, NJ 07055-5209

Phone

(973) 777-3121

Fax

(973) 777-3181

NPI assigned

Dec 14, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Antonio Orestes Rodriguez

Title

President

Phone

(973) 777-3121

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• TONYS PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264982400000",
    "number": "1679558597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 MONROE ST",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555209",
            "telephone_number": "973-777-3121",
            "fax_number": "973-777-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 MONROE ST",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555209",
            "telephone_number": "973-777-3121",
            "fax_number": "973-777-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSAIC PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-14",
        "last_updated": "2010-02-01",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_middle_name": "ORESTES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-777-3121",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NJ",
            "license": "28RS00414400",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "28RS00414400",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00414400",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NJ",
            "license": "28RS00414400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4396707",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1657801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TONYS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Passaic, NJ
• Providers in Passaic, 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 Feb 1, 2010; 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.