Organization Active NPI

Saint Mary'S Pharmacy, Inc.

  • Pharmacy
  • East Brunswick, NJ
National Provider Identifier
1790775633
Registry record updated Nov 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
4990 Issued in NJ
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

Updated by the provider on Nov 25, 2022

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

Authorized official

Name
Mr. Emeel N. Mettias, RPHNPI 1972811644
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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
6301509MedicaidNJ

Other names 1

  • Lexington Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930079188 NJ DME Supplier - Pharmacy 3274645106 Practice locations: East Brunswick, NJ

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.