The Estaugh

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00192000 Issued in NJ

Legal business name

THE ESTAUGH

Practice address

1 Medford Leas
Medford, NJ 08055-2254

Phone

(609) 654-3269

Fax

(609) 257-0827

NPI assigned

Jun 20, 2006

Organization subpart

No

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

Authorized official

Name

Frank Simmons, PHARM D

Title

Phcy Dir

Phone

(609) 654-3391

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• MEDFORD LEAS PHARMACY Doing business as

Tax ID family

Medford Leas3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• The Estaugh

  • Skilled Nursing Facility
  • Medford, NJ
  • NPI 1740279652
  NPD tax ID
• The Estaugh T/a Medford Leas

  • Geriatric Medicine (Family Medicine) Physician
  • Medford, NJ
  • NPI 1659309524
  NPD tax ID

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468972800000",
    "number": "1740226836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDFORD LEAS",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552254",
            "telephone_number": "609-654-3269",
            "fax_number": "609-257-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDFORD LEAS",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552254",
            "telephone_number": "609-654-3269",
            "fax_number": "609-257-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ESTAUGH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2016-07-20",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "PHCY DIR",
        "authorized_official_telephone_number": "609-654-3391",
        "authorized_official_credential": "PHARM D"
    },
    "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": "28RS00192000",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2056046",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4303504",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDFORD LEAS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Sutin, MT-BC
• Tracey Taliaferro
• Joyce Lay Tang
• Russell J Taylor, DDS
• Karen Tennant, LMT
• The Estaugh
• The Estaugh T/a Medford Leas
• The Physical Therapy Company LLC
• Thomas J Marzili MD LLC
• Thomas Marzili MD LLC

• Community/Retail Pharmacy in Medford, NJ
• Providers in Medford, 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 Jul 20, 2016; 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.