Organization Active NPI

Little Ferry Pharmacy, LLC.

  • Pharmacy
  • Little Ferry, NJ
National Provider Identifier
1891362372
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
LITTLE FERRY PHARMACY, LLC.
Practice address
260 Bergen Tpke
Little Ferry, NJ 07643-1104
Phone
(201) 870-6500
Fax
(201) 870-6023
NPI assigned
Jun 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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

Authorized official

Name
Dr. Taehee Park, PHARMD.NPI 1730317520
Title
Pharmacist
Phone
(201) 870-6500

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 Primary

Addresses

Primary practice location

260 Bergen Tpke
Little Ferry, NJ 07643-1104

Mailing address

260 Bergen Tpke
Little Ferry, NJ 07643-1104
Phone (201) 870-6500

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210722002698 NJ DME Supplier - Pharmacy 6103229513 Practice locations: Little Ferry, NJ
O20220322000696 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 6103229513 Practice locations: Little Ferry, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2262560Little Ferry Pharmacy260 Bergen Turnpike, Little Ferry, NJ 07643Certificate of waiverJun 14, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Little Ferry Pharmacy LLC260 Bergen Tpke, Little Ferry, NJ 07643-1104(201) 870-6500 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jul 12, 2021

National Provider Directory

National Provider Directory

Locations

260 Bergen Tpke
Little Ferry, NJ 07643
Phone (201) 641-2030

Practitioners & affiliated clinicians

Practitioners 2

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": "1622764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630972800000",
    "number": "1891362372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 BERGEN TPKE",
            "city": "LITTLE FERRY",
            "state": "NJ",
            "postal_code": "076431104",
            "telephone_number": "201-870-6500",
            "fax_number": "201-870-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 BERGEN TPKE",
            "city": "LITTLE FERRY",
            "state": "NJ",
            "postal_code": "076431104",
            "telephone_number": "201-870-6500",
            "fax_number": "201-870-6023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE FERRY PHARMACY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "TAEHEE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "201-870-6500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Ferry, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.