NPIMap

Organization Active NPI

Acme Markets Inc

Doing business as Acme Pharmacy #1058

  • Community/Retail Pharmacy
  • Mahwah, NJ
National Provider Identifier
1679940654
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00512000 Issued in NJ
Legal business name
ACME MARKETS INC
Doing business as
Acme Pharmacy #1058
Practice address
125 Franklin Tpke
Mahwah, NJ 07430
Phone
(201) 529-9760
Fax
(201) 529-9767
NPI assigned
Aug 26, 2015
Last updated
Jul 24, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 28RS00512000 NJ Primary

Addresses

Primary practice location

125 Franklin Tpke
Mahwah, NJ 07430

Mailing address

250 E Parkcenter Blvd
Mailstop Sec2-B
Boise, ID 83706-3940
Phone (208) 395-3920

Other identifiers 2

IdentifierTypeStateIssuer
0517615MedicaidNJ
2154247OtherPK

Other names 1

  • ACME PHARMACY #1058 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160204000746 NJ DME Supplier - PharmacyDME Supplier - Grocery Store 4082674940 Practice locations: Mahwah, NJ

National Provider Directory

National Provider Directory
Tax ID family
Acme Markets Inc159 organizations share this tax ID, including this one

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.

View all 24

Member of 2

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

  • Albertsons LLC

    dba Sav-On Pharmacy #3174

    • Community/Retail Pharmacy
    • Ammon, ID
    • NPI 1922055383

    Member Of

    NPD member
  • Safeway Inc

    dba Safeway Phamracy #4837

    • Community/Retail Pharmacy
    • District Heights, MD
    • NPI 1588600191

    Member Of

    NPD member

NPI Registry JSON

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532390400000",
    "number": "1679940654",
    "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": "125 FRANKLIN TPKE",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "07430",
            "telephone_number": "201-529-9760",
            "fax_number": "201-529-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACME MARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-26",
        "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": "28RS00512000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0517615",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154247",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ACME PHARMACY #1058",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mahwah, 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.

Verify at the official NPI Registry.