NPIMap

Organization Active NPI

Ranch Health Edison LLC

  • Community/Retail Pharmacy
  • Edison, NJ
National Provider Identifier
1962270256
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
RANCH HEALTH EDISON LLC
Practice address
561 US-1 South
(Unit 101) Inside 99 Ranch
Edison, NJ 08817
Phone
(908) 858-3672
Fax
(908) 460-6778
NPI assigned
Dec 15, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Authorized official

Name
Ms. Cecilia Wong, PHARMDNPI 1104421700
Title
Pharmacist in Charge
Phone
(808) 389-1216

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

561 US-1 South
(Unit 101) Inside 99 Ranch
Edison, NJ 08817

Mailing address

561 US-1 South
(Unit 101) Inside 99 Ranch
Edison, NJ 08817
Phone (908) 858-3672

Other names 1

  • 123 Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240611000729 NJ Part B Supplier - Pharmacy 0941742589 Practice locations: Edison, NJ

National Provider Directory

National Provider Directory
Tax ID family
123 Pharmacy2 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.

Practitioners & affiliated clinicians

Practitioners 4

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": "1702598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1962270256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 US-1 SOUTH",
            "address_2": "(UNIT 101) INSIDE 99 RANCH",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "08817",
            "telephone_number": "908-858-3672",
            "fax_number": "908-460-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 US-1 SOUTH",
            "address_2": "(UNIT 101) INSIDE 99 RANCH",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "08817",
            "telephone_number": "908-858-3672",
            "fax_number": "908-460-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANCH HEALTH EDISON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-15",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "CECILIA",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "808-389-1216",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "123 Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "123 Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.