Active NPI
Saint Mary'S Pharmacy, Inc.
- Pharmacy
- East Brunswick, NJ
National Provider Identifier
1790775633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 4990
- Legal business name
- SAINT MARY'S PHARMACY, INC.
- Practice address
- 3 Lexington Ave
East Brunswick, NJ 08816-5037 - Phone
- (732) 432-0999
- Fax
- (732) 432-0299
- NPI assigned
- Oct 23, 2005
- 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
- Mr. Emeel N. Mettias, RPH
- Title
- Supervising Pharmacist
- Phone
- (732) 881-6355
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 4990 | NJ | Primary |
Addresses
Primary practice location
3 Lexington Ave
East Brunswick, NJ 08816-5037
Mailing address
3 Lexington Ave
East Brunswick, NJ 08816-5037
Phone (732) 432-0999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6301509 | Medicaid | NJ |
Other names 1
- Lexington Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930079188 | NJ | DME Supplier - Pharmacy | 3274645106 | Practice locations: East Brunswick, NJ |
National Provider Directory
National Provider DirectoryLocations
3 Lexington Ave
East Brunswick, NJ 08816
Phone (732) 432-0999
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- East Brunswick, NJ
- NPI 1972811644
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130025600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1669334400000",
"number": "1790775633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 LEXINGTON AVE",
"city": "EAST BRUNSWICK",
"state": "NJ",
"postal_code": "088165037",
"telephone_number": "732-432-0999",
"fax_number": "732-432-0299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 LEXINGTON AVE",
"city": "EAST BRUNSWICK",
"state": "NJ",
"postal_code": "088165037",
"telephone_number": "732-432-0999",
"fax_number": "732-432-0299"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAINT MARY'S PHARMACY, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-23",
"last_updated": "2022-11-25",
"certification_date": "2022-11-25",
"status": "A",
"authorized_official_last_name": "METTIAS",
"authorized_official_first_name": "EMEEL",
"authorized_official_middle_name": "N.",
"authorized_official_title_or_position": "SUPERVISING PHARMACIST",
"authorized_official_telephone_number": "732-881-6355",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NJ",
"license": "4990",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6301509",
"state": "NJ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Lexington Pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Lexington Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in East Brunswick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2022; 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.