Organization Active NPI

Bayonne RX Apothecary Inc

Doing business as Bayonne Rx Apothecary

  • Community/Retail Pharmacy
  • Bayonne, NJ
National Provider Identifier
1710495379
Registry record updated Nov 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00761700 Issued in NJ
Legal business name
BAYONNE RX APOTHECARY INC
Doing business as
Bayonne Rx Apothecary
Midtown Pharmacy Bayonne
Practice address
490 Broadway
Bayonne, NJ 07002-3696
Phone
(201) 471-2537
Fax
(201) 471-2538
NPI assigned
Jan 17, 2018
Last updated
Nov 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2023

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

Authorized official

Name
Muhammad SiddiqueNPI 1033798210
Title
President
Phone
(929) 434-8488

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 28RS00761700 NJ Primary

Addresses

Primary practice location

490 Broadway
Bayonne, NJ 07002-3696

Mailing address

490 Broadway
Bayonne, NJ 07002-3696
Phone (201) 471-2537

Other identifiers 1

IdentifierTypeStateIssuer
2176913OtherPK

Other names 2

  • Bayonne Rx Apothecary Doing business as
  • MIDTOWN PHARMACY BAYONNE Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210310002827 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 9638410798 Practice locations: Bayonne, NJ
O20240108005237 NJ Part B Supplier - Pharmacy 9638410798 Practice locations: Bayonne, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1516147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699056000000",
    "number": "1710495379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023696",
            "telephone_number": "201-471-2537",
            "fax_number": "201-471-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023696",
            "telephone_number": "201-471-2537",
            "fax_number": "201-471-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYONNE RX APOTHECARY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-17",
        "last_updated": "2023-11-04",
        "certification_date": "2023-11-04",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUE",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "929-434-8488"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00761700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176913",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayonne Rx Apothecary",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bayonne Rx Apothecary",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MIDTOWN PHARMACY BAYONNE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bayonne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2023; 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.