Active NPI
Jack Philips II, PHARMD
- Pharmacist
- East Windsor, NJ
National Provider Identifier
1942073523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI04335900
- Practice address
- 104 Hickory Corner Rd
East Windsor, NJ 08520-2460 - Phone
- (609) 308-2887
- NPI assigned
- Nov 6, 2023
- Last updated
- Nov 6, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI04335900 | NJ | Primary |
Addresses
Primary practice location
104 Hickory Corner Rd
East Windsor, NJ 08520-2460
Mailing address
10 Bridle CT
Jackson, NJ 08527-4488
Phone (732) 575-2615
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI04335900 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mahant Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Blue Swan Pharmacy - East Windsor
- Long Term Care Pharmacy
- East Windsor, NJ
- NPI 1235915463
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699228800000",
"number": "1942073523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 BRIDLE CT",
"city": "JACKSON",
"state": "NJ",
"postal_code": "085274488",
"telephone_number": "732-575-2615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 HICKORY CORNER RD",
"city": "EAST WINDSOR",
"state": "NJ",
"postal_code": "085202460",
"telephone_number": "609-308-2887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILIPS",
"first_name": "JACK",
"name_suffix": "II",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-11-06",
"last_updated": "2023-11-06",
"certification_date": "2023-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI04335900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Windsor, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.