Madura Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00116700 Issued in NJ

Legal business name

MADURA PHARMACY LLC

Doing business as

Madura Pharmacy LLC

Practice address

115 N Broadway
South Amboy, NJ 08879-1660

Phone

(732) 721-1732

Fax

(732) 721-5840

NPI assigned

Jun 18, 2006

Organization subpart

No

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

Authorized official

Name

Anne Wolpin

Title

Auth Rep

Phone

(732) 721-1732

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Madura Pharmacy LLC Doing business as

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308182400000",
    "number": "1699710079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N BROADWAY",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088791660",
            "telephone_number": "732-721-1732",
            "fax_number": "732-721-5840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N BROADWAY",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088791660",
            "telephone_number": "732-721-1732",
            "fax_number": "732-721-5840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADURA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2011-06-16",
        "status": "A",
        "authorized_official_last_name": "WOLPIN",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "AUTH REP",
        "authorized_official_telephone_number": "732-721-1732"
    },
    "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": "28RS00116700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3115234",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4249801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madura Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Longevity Medical LLC
• Elizabeth Guadalupe Lopez
• Thomas Lusch, PEER SPECIALIST
• Erica A Lyudin, RN
• Hannah Madera, BCBA
• Madura RX LLC
• Madura RX LLC
• Joseph J Madura, D.M.D.
• Justin Mairs
• Iqra Malik

• Community/Retail Pharmacy in South Amboy, NJ
• Providers in South Amboy, 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 Jun 16, 2011; 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.