Organization Active NPI

Apollo Pharmacy Inc

  • Community/Retail Pharmacy
  • Newark, NJ
National Provider Identifier
1770011371
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00756500 Issued in NJ
Legal business name
APOLLO PHARMACY INC
Practice address
130 Summer Ave
Newark, NJ 07104-1903
Phone
(973) 350-6155
Fax
(973) 556-1560
NPI assigned
May 25, 2017
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Bhavesh Gajera, RPH
Title
Owner
Phone
(973) 350-6155

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 28RS00756500 NJ Primary

Addresses

Primary practice location

130 Summer Ave
Newark, NJ 07104-1903

Mailing address

130 Summer Ave
Newark, NJ 07104-1903
Phone (973) 350-6155

Other identifiers 2

IdentifierTypeStateIssuer
0605476MedicaidNJ
2169039OtherPK

Other names 1

  • APOLLO PHARMACY Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1495670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1770011371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SUMMER AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071041903",
            "telephone_number": "973-350-6155",
            "fax_number": "973-556-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 SUMMER AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071041903",
            "telephone_number": "973-350-6155",
            "fax_number": "973-556-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APOLLO PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-25",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "GAJERA",
        "authorized_official_first_name": "BHAVESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-350-6155",
        "authorized_official_credential": "RPH"
    },
    "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": "28RS00756500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0605476",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2169039",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "APOLLO PHARMACY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jun 16, 2018; 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.