Elizabeth Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00718500 Issued in NJ

Legal business name

ELIZABETH PHARMACY INC

Practice address

638 Bayway Ave
Elizabeth, NJ 07202-2613

Phone

(908) 527-1112

Fax

(908) 527-1155

NPI assigned

Jun 15, 2012

Organization subpart

No

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

Authorized official

Name

Prabodh Ajbani

Title

Shareholder

Phone

(908) 527-1112

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Goethals Pharmacy Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475193600000",
    "number": "1811259716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 BAYWAY AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072022613",
            "telephone_number": "908-527-1112",
            "fax_number": "908-527-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 BAYWAY AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072022613",
            "telephone_number": "908-527-1112",
            "fax_number": "908-527-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-15",
        "last_updated": "2016-09-30",
        "status": "A",
        "authorized_official_last_name": "AJBANI",
        "authorized_official_first_name": "PRABODH",
        "authorized_official_title_or_position": "SHAREHOLDER",
        "authorized_official_telephone_number": "908-527-1112"
    },
    "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": "28RS00718500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0346527",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2137381",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goethals Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Medical Associates LLC
• Elizabeth Medical Diagnostic Associates Inc
• Elizabeth Medical Group PA
• Elizabeth Oral and Maxillofacial Surgical Group LLC
• Elizabeth Pediatric Group, LLC
• Elizabeth Physical Therapy & Elizabeth Foot and Ankle Association
• Elizabeth Primary Care, LLC
• Elizabeth Public Schools
• Elizabeth Radiology Associates, P.a.
• Elizabeth Smiline Dental, LLC

• Community/Retail Pharmacy in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; 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.