1316261415 NPI number — NEWTON SPECIALITY PHARMACY INC

Table of content: (NPI 1316261415)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316261415 NPI number — NEWTON SPECIALITY PHARMACY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEWTON SPECIALITY PHARMACY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NEWTON PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316261415
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/13/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
171 FOREST DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PISCATAWAY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08854-2273
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-769-8014
Provider Business Mailing Address Fax Number:
888-845-2221

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
NEWTON PHARMACY
Provider Second Line Business Practice Location Address:
67 HIGH STREET
Provider Business Practice Location Address City Name:
NEWTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07860
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-383-0044
Provider Business Practice Location Address Fax Number:
888-845-2221
Provider Enumeration Date:
03/17/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KALIDINDI
Authorized Official First Name:
PREM
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACIST
Authorized Official Telephone Number:
917-769-8014

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 28RS00701800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3196854 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".