1699003905 NPI number — DGN PHARMACY, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699003905 NPI number — DGN PHARMACY, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DGN 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:
Provider Other Organization Name Type Code:
6
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:
1699003905
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 MURRAY HILL PKWY
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
EAST RUTHERFORD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07073
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-430-7300
Provider Business Mailing Address Fax Number:
201-438-5050

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 MURRAY HILL PKWY
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
EAST RUTHERFORD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07073
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-430-7300
Provider Business Practice Location Address Fax Number:
201-438-5050
Provider Enumeration Date:
11/24/2009

Additional Information

Authorized Official

Authorized Official Last Name:
MARGOLIS
Authorized Official First Name:
LAWRENCE
Authorized Official Middle Name:
Authorized Official Title or Position:
FOUNDER AND CEO
Authorized Official Telephone Number:
201-430-7300

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  NRP1954 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PHY.007121-NR , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: OSP.0006697 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PHNR000834 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 5301011197 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PCN.0002359 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 4588 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PH28880 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 64001950A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PMP-1207 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 40557MS , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 054.019654 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: NRX0000833 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: MO40001778 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 114490 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2122893 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 107440300 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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