Organization Active NPI

Uli RX Inc

Doing business as Irving Pharmacy

  • Pharmacist
  • Paterson, NJ
National Provider Identifier
1962511675
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI02394600 Issued in NJ
Legal business name
ULI RX INC
Doing business as
Irving Pharmacy
Practice address
382 Main Street
Paterson, NJ 07501
Phone
(973) 742-8186
Fax
(973) 742-8187
NPI assigned
Aug 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Mr. Ullas Philip Thannickal, RPLNPI 1740685163
Title
President
Phone
(973) 742-8186

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
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 28RI02394600 NJ Primary

Addresses

Primary practice location

382 Main Street
Paterson, NJ 07501

Mailing address

382 Main Street
Paterson, NJ 07501
Phone (973) 742-8186

Other identifiers 2

IdentifierTypeStateIssuer
0014630MedicaidNJ
0014664MedicaidNJ

Other names 1

  • Irving Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110107000435 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 7012124753 Practice locations: Paterson, NJ

National Provider Directory

National Provider Directory

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": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1962511675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 MAIN STREET",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "07501",
            "telephone_number": "973-742-8186",
            "fax_number": "973-742-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 MAIN STREET",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "07501",
            "telephone_number": "973-742-8186",
            "fax_number": "973-742-8187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULI RX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "THANNICKAL",
        "authorized_official_first_name": "ULLAS",
        "authorized_official_middle_name": "PHILIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-742-8186",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPL"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02394600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014630",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014664",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Irving Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.