Organization Active NPI

NPC Pharma LLC

  • Community/Retail Pharmacy
  • Elizabeth, NJ
National Provider Identifier
1811882038
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
NPC PHARMA LLC
Doing business as
ELIZABETH PHARMACY
Practice address
1164 E Jersey St
Elizabeth, NJ 07201-2311
Phone
(908) 994-1525
Fax
(908) 994-1508
NPI assigned
Jun 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Authorized official

Name
Michael ModzelewskiNPI 1245360064
Title
Supervising Pharmacist
Phone
(908) 994-1525

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
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1164 E Jersey St
Elizabeth, NJ 07201-2311

Mailing address

1164 E Jersey St
Elizabeth, NJ 07201-2311
Phone (908) 994-1525

Other names 1

  • ELIZABETH PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250912000728 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 9436652765 Practice locations: Elizabeth, NJ
O20251028003423 NJ DME Supplier - Pharmacy 9436652765 Practice locations: Elizabeth, NJ

National Provider Directory

National Provider Directory
Tax ID family
NPC Pharma LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1749427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1811882038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1164 E JERSEY ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072012311",
            "telephone_number": "908-994-1525",
            "fax_number": "908-994-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1164 E JERSEY ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072012311",
            "telephone_number": "908-994-1525",
            "fax_number": "908-994-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NPC PHARMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "MODZELEWSKI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "908-994-1525"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELIZABETH PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.