NPIMap

Organization Active NPI

St Maria Pharmacy

  • Health Maintenance Organization
  • East Brunswick, NJ
National Provider Identifier
1972038446
Registry record updated Apr 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
28RI03792000 Issued in NJ
Legal business name
ST MARIA PHARMACY
Practice address
1004 Commons Dr
East Brunswick, NJ 08816-5217
Phone
(732) 485-9570
NPI assigned
Apr 21, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2017

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

Authorized official

Name
Randa Wisa, RPHNPI 1831626530
Title
Pharmacist in Charge
Phone
(732) 485-9570

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
Health Maintenance Organization 302R00000X 28RI03792000 NJ Primary

Addresses

Primary practice location

1004 Commons Dr
East Brunswick, NJ 08816-5217

Mailing address

1004 Commons Dr
East Brunswick, NJ 08816-5217
Phone (732) 485-9570

National Provider Directory

National Provider Directory
Tax ID family
St Maria 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 1

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": "1492732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492732800000",
    "number": "1972038446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 COMMONS DR",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165217",
            "telephone_number": "732-485-9570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 COMMONS DR",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165217",
            "telephone_number": "732-485-9570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARIA PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-21",
        "last_updated": "2017-04-21",
        "status": "A",
        "authorized_official_last_name": "WISA",
        "authorized_official_first_name": "RANDA",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "732-485-9570",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NJ",
            "license": "28RI03792000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; 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.