NPIMap

Organization Active NPI

HMH Hospitals Corporation

Doing business as Hackensack Meridian Health Pharmacy at Southern Ocean Medical Center

  • Pharmacy
  • Manahawkin, NJ
National Provider Identifier
1992337505
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
HMH HOSPITALS CORPORATION
Doing business as
Hackensack Meridian Health Pharmacy at Southern Ocean Medical Center
Practice address
1140 Route 72 W
Manahawkin, NJ 08050-2412
Phone
(609) 978-4454
Fax
(609) 978-3181
NPI assigned
Feb 11, 2020
Last updated
Feb 11, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
HMH HOSPITALS CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Authorized official

Name
Matthew Tarullo, PHARMD
Title
Pharmacy Manager
Phone
(609) 978-4454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary

Addresses

Primary practice location

1140 Route 72 W
Manahawkin, NJ 08050-2412

Mailing address

1140 Route 72 W
Manahawkin, NJ 08050-2412
Phone (609) 978-4454

Other names 1

  • Hackensack Meridian Health Pharmacy at Southern Ocean Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200430001049 NJ DME Supplier - Pharmacy 9032181847 Practice locations: Manahawkin, NJ
O20240703003499 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 9032181847 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Edison, NJ; Manahawkin, NJ

Other NPIs with the same Medicare PAC ID 21

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 21

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
HMH Pharmacy at Somc1140 Route 72 W, Manahawkin, NJ 08050-2412(609) 978-3004 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Feb 12, 2018

National Provider Directory

National Provider Directory
Tax ID family
George B Jacobs MD45 organizations share this tax ID, including this one
Part of
George B Jacobs MD

Other organizations with this tax ID 44

Organizations that report the same tax identification number in the National Provider Directory.

View all 44

Ownership & related parties

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hackensack Meridian Health Carrier ClinicBelle Mead, NJ, CCN 314012 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2021
Hackensack Meridian Health, Mountainside Medical CenterMontclair, NJ, CCN 310054 Hospital 5% Or Greater Direct Ownership Interest Feb 20, 2014
Hackensack University Medical Center - Psychiatric UnitHackensack, NJ, CCN 31S001 Hospital Operational/Managerial Control (100%) Jan 1, 2018
Hackensack Meridian Health, Pascack ValleyWestwood, NJ, CCN 310130 Hospital 5% Or Greater Indirect Ownership Interest (35%) Jan 16, 2009
Hackensack Meridian Health, Mountainside Medical CenterMontclair, NJ, CCN 31S054 Hospital 5% Or Greater Direct Ownership Interest Feb 20, 2014
Hackensack Meridian Ltach LLCPerth Amboy, NJ, CCN 312025 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2016
Complete Care at Harborage LLCNorth Bergen, NJ, CCN 315307 Skilled nursing facility Adp of the SNF Mar 16, 2023

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581379200000",
    "number": "1992337505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 ROUTE 72 W",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080502412",
            "telephone_number": "609-978-4454",
            "fax_number": "609-978-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 ROUTE 72 W",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080502412",
            "telephone_number": "609-978-4454",
            "fax_number": "609-978-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HMH HOSPITALS CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HMH HOSPITALS CORPORATION",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "TARULLO",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "609-978-4454",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hackensack Meridian Health Pharmacy at Southern Ocean Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manahawkin, NJ

Sources for this page

Verify at the official NPI Registry.