Organization Active NPI

Bop RX Inc

Doing business as Black Oak Pharmacy

  • Community/Retail Pharmacy
  • Wayne, NJ
National Provider Identifier
1790295616
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00759100 Issued in NJ
Legal business name
BOP RX INC
Doing business as
Black Oak Pharmacy
Practice address
879 Black Oak Ridge Rd Unit 2
Wayne, NJ 07470-6400
Phone
(973) 837-8770
Fax
(973) 837-8771
NPI assigned
Oct 5, 2017
Last updated
Sep 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Authorized official

Name
Jonathan RuditserNPI 1104105899
Title
Vice President
Phone
(973) 837-8770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 28RS00759100 NJ Primary

Addresses

Primary practice location

879 Black Oak Ridge Rd Unit 2
Wayne, NJ 07470-6400

Mailing address

879 Black Oak Ridge Rd
Unit #2
Wayne, NJ 07470-6400
Phone (973) 837-8770

Other identifiers 2

IdentifierTypeStateIssuer
2171984OtherPK
0606014MedicaidNJ

Other names 1

  • Black Oak Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180208001922 NJ Part B Supplier - Pharmacy 6608136825 Practice locations: Wayne, NJ

National Provider Directory

National Provider Directory

Locations

879 Black Oak Ridge Rd
#2
Wayne, NJ 07470
Phone (973) 837-8770

879 Black Oak Ridge Rd
Unit 2
Wayne, NJ 07470
Phone (973) 837-8770

Practitioners & affiliated clinicians

Practitioners 3

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": "1507161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1790295616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "879 BLACK OAK RIDGE RD",
            "address_2": "UNIT #2",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074706400",
            "telephone_number": "973-837-8770",
            "fax_number": "973-837-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "879 BLACK OAK RIDGE RD UNIT 2",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074706400",
            "telephone_number": "973-837-8770",
            "fax_number": "973-837-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOP RX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-05",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "RUDITSER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "973-837-8770"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00759100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2171984",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0606014",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Black Oak Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Black Oak Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.