IMPRIMISRX NJ, LLC (NPI# 1396870986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396870986 |
| Entity Type | Organization |
| Organization Name | IMPRIMISRX NJ, LLC |
| Other Organization Name | IMPRIMISRX |
| Practice Address |
1705 Route 46 Ste 4 Ledgewood NJ 07852-9720 |
| Mailing Address |
12264 El Camino Real Suite 350 San Diego CA 92130-0001 |
| Practice Telephone | 8444466979 |
| Practice Fax Number | 8554054669 |
| Mailing Telephone | 8587044040 |
| Mailing Fax Number | 8583451745 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2019-10-24 |
| Authorized Official Name | MR. ANDREW RICHARD BOLL (SECRETARY & CFO) |
| Authorized Official Telephone | 8587044040 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
28RS00593300 | NJ | Suppliers |
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
28RS00593300 | NJ | Suppliers |
| Y | 333600000X | Pharmacy | 28RS00593300 | NJ | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | NCPDP | 3143017 | 01 |
| Other Name | Type Code |
|---|---|
| ImprimisRx | Doing Business As Name - Organization |
| Street Address |
1705 ROUTE 46 STE 4 |
| City | LEDGEWOOD |
| State | NJ |
| Zip Code | 07852-9720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396677 | Shivaniben Shah | Pharmacist | 461 Rt 10 A100, Ledgewood, NJ 07852 | 2020-11-06 |
| 1730798851 | Wal-mart Stores East, Lp | Technician/Technologist | 461 Rt 10 Suite A100, Ledgewood, NJ 07852 | 2020-07-24 |
| 1700262466 | Danielle Gaeta | Optometrist | 410 State Route 10 West, Suite 202, Ledgewood, NJ 07852 | 2015-08-05 |
| 1639550551 | Allies, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 104 Woods Edge Dr, Ledgewood, NJ 07852 | 2015-06-16 |
| 1407190523 | Ryan Mark Stenvall | Dentist | 410 Route 10 West, Suite 209, Ledgewood, NJ 07852 | 2012-11-15 |
| 1194020834 | Wanda Ivette Lopez-rodriguez | Nurse Practitioner | 1105 Route 46, Ledgewood, NJ 07852 | 2011-01-11 |
| 1285949750 | Walter Beckford Od | Optometrist | 461 Route 10 Suite 29, Ledgewood, NJ 07852 | 2010-08-09 |
| 1558537233 | Leonard J. Grossman. Md | Exclusive Provider Organization | 1911 Route 46, Ledgewood, NJ 07852 | 2008-05-02 |
| 1164520987 | New Jersey Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1105 Rte 46, Ledgewood, NJ 07852 | 2006-09-20 |
| 1548275530 | Walgreen Co | Pharmacy | 1131 Route 46, Ledgewood, NJ 07852 | 2006-07-29 |
| Find all providers in zip 07852 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801495544 | Medilink Rxcare Hammonton, LLC | Pharmacy | 44 S White Horse Pike, Hammonton, NJ 08037-1845 | 2020-10-23 |
| 1770193757 | Rvl Pharmacy | Pharmacy | 2500 Main St Ste 10, Sayreville, NJ 08872-1473 | 2020-08-05 |
| 1043828577 | Siddhivinayak Inc. | Pharmacy | 90 Bergen St # 1600, Newark, NJ 07103-2425 | 2020-07-21 |
| 1891303616 | Amwell Pharmacy Inc. | Pharmacy | 438 Route 206 Ste 3, Hillsborough, NJ 08844-5525 | 2020-07-17 |
| 1366066235 | Brx LLC | Pharmacy | 250 Chambers Bridge Rd, Brick, NJ 08723 | 2020-06-05 |
| 1982237103 | Holmdel Pharmacy and Deli LLC | Pharmacy | 487 Middle Rd, Hazlet, NJ 07730-2426 | 2020-02-17 |
| 1184254575 | Frrx LLC | Pharmacy | 76 W Gilbert St, Tinton Falls, NJ 07701-4918 | 2020-01-24 |
| 1841820388 | Ewing Pharmacy LLC | Pharmacy | 1400 Parkway Ave Ste A2, Ewing, NJ 08628-3021 | 2020-01-23 |
| 1982240735 | Elite Rx LLC | Pharmacy | 2282 Hamburg Tpke Ste E, Wayne, NJ 07470-6291 | 2019-11-26 |
| 1629626163 | Meadowlands Pharmacy LLC | Pharmacy | 40, Meadowlands Pkway, Secaucus, NJ 07094 | 2019-08-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.