Organization Active NPI

Wintergreen Pharmacy Corporation

Doing business as Westminster Pharmacy

  • Community/Retail Pharmacy
  • Elizabeth, NJ
National Provider Identifier
1689760936
Registry record updated Aug 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00629000 Issued in NJ
Legal business name
WINTERGREEN PHARMACY CORPORATION
Doing business as
Westminster Pharmacy
Practice address
577 N Broad St
Elizabeth, NJ 07208-3354
Phone
(908) 352-7111
Fax
(908) 352-2873
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2014

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

Authorized official

Name
Arshad Mahmud
Title
Phcy MGR
Phone
(908) 352-7111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 28RS00629000 NJ Primary

Addresses

Primary practice location

577 N Broad St
Elizabeth, NJ 07208-3354

Mailing address

577 N Broad St
Elizabeth, NJ 07208-3354
Phone (908) 352-7111

Other identifiers 2

IdentifierTypeStateIssuer
3145706OtherNCPDP PROVIDER IDENTIFICATION NUMBER
0013650MedicaidNJ

Other names 1

  • WESTMINSTER PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

577 N Broad St
Elizabeth, NJ 07208
Phone (908) 352-7111

Practitioners & affiliated clinicians

Practitioners 1

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": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408060800000",
    "number": "1689760936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 N BROAD ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083354",
            "telephone_number": "908-352-7111",
            "fax_number": "908-352-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 N BROAD ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083354",
            "telephone_number": "908-352-7111",
            "fax_number": "908-352-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINTERGREEN PHARMACY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2014-08-15",
        "status": "A",
        "authorized_official_last_name": "MAHMUD",
        "authorized_official_first_name": "ARSHAD",
        "authorized_official_title_or_position": "PHCY MGR",
        "authorized_official_telephone_number": "908-352-7111"
    },
    "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": "28RS00629000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3145706",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0013650",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WESTMINSTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2014; 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.