Bethel Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00627600 Issued in NJ

Legal business name

BETHEL PHARMACY

Practice address

301 Osborne Ter
Newark, NJ 07112-2153

Phone

(973) 391-0101

Fax

(973) 391-0107

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Ademola Salami

Title

Pic

Phone

(973) 391-0101

Specialties & licenses 2

Addresses

Other identifiers 3

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1982758330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 OSBORNE TER",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 OSBORNE TER",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122153",
            "telephone_number": "973-391-0101",
            "fax_number": "973-391-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "SALAMI",
        "authorized_official_first_name": "ADEMOLA",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "973-391-0101"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00627600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3145578",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018546",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "3145578",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; 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.