NPIMap

Organization Active NPI

New Lucy'S Pharmacy Inc

  • Community/Retail Pharmacy
  • Passaic, NJ
National Provider Identifier
1992843155
Registry record updated Apr 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00681100 Issued in NJ
Legal business name
NEW LUCY'S PHARMACY INC
Practice address
286 288 Monroe Street
Passaic, NJ 07055
Phone
(973) 778-4495
Fax
(973) 778-8843
NPI assigned
Feb 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2017

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

Authorized official

Name
Mr. Samir M Awad
Title
President
Phone
(973) 778-4495

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 28RS00681100 NJ Primary

Addresses

Primary practice location

286 288 Monroe Street
Passaic, NJ 07055

Mailing address

286-288 Monroe St Unit B
Passaic, NJ 07055-5271
Phone (973) 778-4495

Other identifiers 2

IdentifierTypeStateIssuer
0536920MedicaidNJ
0231916MedicaidNJ

Other names 1

  • same Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930059021 NJ DME Supplier - Pharmacy 4284831884 Practice locations: Passaic, NJ

National Provider Directory

National Provider Directory
Tax ID family
New Lucy'S Pharmacy Inc2 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.

Locations

286 Monroe St
Passaic, NJ 07055
Phone (973) 778-4495

286-288 Monroe St
Unit B
Passaic, NJ 07055

286-288 Monroe St
Passaic, NJ 07055
Phone (973) 778-4495

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491523200000",
    "number": "1992843155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286-288 MONROE ST UNIT B",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555271",
            "telephone_number": "973-778-4495",
            "fax_number": "973-778-8843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 288 MONROE STREET",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "07055",
            "telephone_number": "973-778-4495",
            "fax_number": "973-778-8843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LUCY'S PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2017-04-07",
        "status": "A",
        "authorized_official_last_name": "AWAD",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-778-4495",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00681100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0536920",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0231916",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "same",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Passaic, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; 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.