Active NPI
Yamna LLC
- Community/Retail Pharmacy
- Newark, NJ
National Provider Identifier
1760530968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 28RS00419200
- Legal business name
- YAMNA LLC
- Practice address
- 1069 Bergen St
Newark, NJ 07112 - Phone
- (973) 926-4100
- Fax
- (973) 926-9650
- NPI assigned
- Jan 7, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ankur Barot, PHARMACIST
- Title
- Owner
- Phone
- (973) 926-4100
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 28RS00419200 | NJ | |
| Community/Retail Pharmacy | 3336C0003X | 28RS00419200 | NJ | Primary |
Addresses
Primary practice location
1069 Bergen St
Newark, NJ 07112
Mailing address
1069 Bergen St
Newark, NJ 07112-2039
Phone (973) 926-4100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4398807 | Medicaid | NJ | |
| 0566659 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221208001091 | NJ | Part B Supplier - Independent Clinical Laboratory | 2466796123 | Practice locations: Newark, NJ |
| O20230523000104 | NJ | Part B Supplier - Pharmacy | 2466796123 | Practice locations: Newark, NJ |
National Provider Directory
National Provider DirectoryLocations
1069 Bergen St
Newark, NJ 07112
Phone (973) 926-4100
90 Woodbridge Center Dr
Ste 900
Woodbridge, NJ 07095
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Watchung, NJ
- NPI 1295286193
-
- Pharmacist
- Piscataway, NJ
- NPI 1508103607
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168128000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1532304000000",
"number": "1760530968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1069 BERGEN ST",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071122039",
"telephone_number": "973-926-4100",
"fax_number": "973-926-9650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1069 BERGEN ST",
"city": "NEWARK",
"state": "NJ",
"postal_code": "07112",
"telephone_number": "973-926-4100",
"fax_number": "973-926-9650"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "YAMNA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-07",
"last_updated": "2018-07-23",
"status": "A",
"authorized_official_last_name": "BAROT",
"authorized_official_first_name": "ANKUR",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "973-926-4100",
"authorized_official_credential": "PHARMACIST"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NJ",
"license": "28RS00419200",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NJ",
"license": "28RS00419200",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4398807",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0566659",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; 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.