Organization Active NPI

Essgee Phillipsburg Corp

  • Community/Retail Pharmacy
  • Phillipsburg, NJ
National Provider Identifier
1740207679
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00675900 Issued in NJ
Legal business name
ESSGEE PHILLIPSBURG CORP
Practice address
96 Baltimore St
Phillipsburg, NJ 08865-1836
Phone
(908) 454-4352
Fax
(908) 454-4377
NPI assigned
Jul 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Authorized official

Name
Sreedhar Vajinepalli
Title
President
Phone
(443) 528-1008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 28RS00675900 NJ Primary

Addresses

Primary practice location

96 Baltimore St
Phillipsburg, NJ 08865-1836

Mailing address

96 Baltimore St
Phillipsburg, NJ 08865-1836
Phone (908) 454-4352

Other identifiers 2

IdentifierTypeStateIssuer
0321711MedicaidNJ
3103520OtherNJNCPDP

Other names 1

  • Phillipsburg Pharmacy Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20121023000081 NJ DME Supplier - Pharmacy 2466602750 Practice locations: Phillipsburg, NJ
O20201119000187 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 2466602750 Practice locations: Phillipsburg, NJ

National Provider Directory

National Provider Directory
Tax ID family
Phillipsburg Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

96 Baltimore St
Phillipsburg, NJ 08865
Phone (908) 454-3470

Practitioners & affiliated clinicians

Practitioners 4

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": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1740207679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 BALTIMORE ST",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651836",
            "telephone_number": "908-454-4352",
            "fax_number": "908-454-4377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 BALTIMORE ST",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651836",
            "telephone_number": "908-454-4352",
            "fax_number": "908-454-4377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSGEE PHILLIPSBURG CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "VAJINEPALLI",
        "authorized_official_first_name": "SREEDHAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "443-528-1008"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00675900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0321711",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3103520",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phillipsburg Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phillipsburg, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; 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.