Shubha C Kodamballi

Primary specialty

PharmacistTaxonomy code 183500000X

License

28RI04163300 Issued in NJ

Practice address

3191 State Route 27
Franklin Park, NJ 08823-1356

Phone

(732) 798-6076

Fax

(732) 798-6078

NPI assigned

Feb 20, 2021

Last updated

Feb 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Anuj RX LLC

  dba Ultra Care Pharmacy

  • Community/Retail Pharmacy
  • Franklin Park, NJ
  • NPI 1215305438
  NPD (past)

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

{
    "created_epoch": "1613779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613779200000",
    "number": "1740873769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 WALLACE BLVD",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088443441",
            "telephone_number": "732-688-2369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3191 STATE ROUTE 27",
            "city": "FRANKLIN PARK",
            "state": "NJ",
            "postal_code": "088231356",
            "telephone_number": "732-798-6076",
            "fax_number": "732-798-6078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODAMBALLI",
        "first_name": "SHUBHA",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-20",
        "last_updated": "2021-02-20",
        "certification_date": "2021-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI04163300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Kannapel, RMT-REIKIMASTER
• Francis R Kares, RPH
• Ranjita Kasukurthi
• Mandeep Kaur, PHARM D
• Ayesha Kiran, M.D.
• Ira Krumholtz, O.D.
• Legacy Treatment Serivces, Inc.
• Winifred Fong Leung, MD
• Haiying Liu, RPH
• Logoley Dialysis LLC (Franklin Park Dialysis)

• Pharmacist in Franklin Park, NJ
• Providers in Franklin Park, NJ by specialty
• Pharmacist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2021; 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.