Eckerd Corporation
Organization Active NPI Community/Retail Pharmacy · Mantua, NJ
NPI 1902905136 · NPPES record last updated Aug 2, 2011
Key facts
- NPI
- 1902905136
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 28RS00488700 (NJ)
- Legal business name
- ECKERD CORPORATION
- Practice address
- 210 Bridgeton Pike
Mantua, NJ 08051-1915 - Phone
- (856) 468-5513
- NPI assigned
- Sep 22, 2006
- Organization subpart
- No
Authorized official
- Name
- Jennifer Zorek
- Title
- Manager Online Adjudication
- Phone
- (717) 975-5937
Practitioners 2
-
James A Matsuk Jr., RPH
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100222000377 | NJ | Part B Supplier - Mass Immunization (Roster Biller Only) | 4082699152 |
This NPI is an additional NPI on the enrollment Practice locations: Pilesgrove, NJ; Port Monmouth, NJ; Sicklerville, NJ; Toms River, NJ; Vineland, NJ; Glassboro, NJ; Voorhees, NJ; Whiting, NJ… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | 28RS00488700 | NJ | Yes |
Addresses
Primary practice location
210 Bridgeton Pike
Mantua, NJ 08051-1915
Mailing address
200 Newberry Commons
Etters, PA 17319-9363
Phone (717) 761-2633
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3135060 | Other | OTHER ID NUMBER | |
| 6018505 | Medicaid | NJ | |
| 6018513 | Other | NJ | MEDICAID DME |
Other names
- RITE AID PHARMACY 10449
Other providers in Mantua, NJ
- Cristina D'Amelio
- Sagar Dalal
- Tulley Delzell
- Dr. Steven S. Roth, West Deptford Eye Care
- Jenni Earp
- Elshiva Developmental Services
- Behrad Emami
- Fanelli Chiropractic & Muscle Treatment
- Rose Fedechko
- Jennifer V Fratini
All providers in Mantua, NJ · Community/Retail Pharmacy in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.