SPG Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00566700 Issued in NJ

Legal business name

SPG PHARMACY INC

Doing business as

ROSEVILLE PHARMACY

Practice address

500 Orange St
Newark, NJ 07107

Phone

(973) 484-1258

Fax

(973) 482-4080

NPI assigned

Nov 18, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Umesh R Patel, R.PH

Title

President

Phone

(973) 484-1258

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ROSEVILLE PHARMACY Doing business as

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

{
    "created_epoch": "1163808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225670400000",
    "number": "1891869228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ORANGE ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07107",
            "telephone_number": "973-484-1258",
            "fax_number": "973-482-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ORANGE ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07107",
            "telephone_number": "973-484-1258",
            "fax_number": "973-482-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPG PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-18",
        "last_updated": "2008-11-03",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "UMESH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-484-1258",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00566700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7845502",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ROSEVILLE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Newark, NJ
• Providers in Newark, 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 Nov 3, 2008; 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.