PEGASUS PHARMACY LLC (NPI# 1689920498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689920498 |
| Entity Type | Organization |
| Organization Name | PEGASUS PHARMACY LLC |
| Other Organization Name | LEGACY PHARMACY |
| Practice Address |
2050 Springdale Rd Unit 500 Cherry Hill NJ 08003-2045 |
| Mailing Address |
2050 Springdale Rd. Unit 500 Cherry Hill NJ 08003 |
| Practice Telephone | 8565283900 |
| Practice Fax Number | 8564242096 |
| Mailing Telephone | 8565283900 |
| Mailing Fax Number | 8564242096 |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2018-07-19 |
| Authorized Official Name | JOEL MORTON (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 6025616432 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
28RS00723000 | NJ | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2136982 | 01 |
| Other Name | Type Code |
|---|---|
| Legacy Pharmacy | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Vermont Business Registrations | PEGASUS PHARMACY LLC | 2050 Springdale Rd #500, Cherry Hill, NJ 08003 |
| Street Address |
2050 SPRINGDALE RD UNIT 500 |
| City | CHERRY HILL |
| State | NJ |
| Zip Code | 08003-2045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528695483 | Yvonne Lee | Registered Nurse | Nbn Group, 2 Pin Oak Lane, Suite 250, Cherry Hill, NJ 08003 | 2020-03-23 |
| 1639717945 | Nancy Sue Epstein | Occupational Therapist | 1817 E. Fireside Court -tools for Healing LLC, Cherry Hill, NJ 08003 | 2019-12-17 |
| 1346885126 | Martin Igoe | Nurse Practitioner | 1865 Rt 70 East, Cherry Hill, NJ 08003 | 2019-11-15 |
| 1881242840 | Emily Lott | Nurse Practitioner | 1865 Rte 70 E, Cherry Hill, NJ 08003 | 2019-09-03 |
| 1417502378 | Periodontal Consultants, Pa | Dentist | 1910 East Marlton Pike, The Atrium Suite #2, Cherry Hill, NJ 08003 | 2019-08-07 |
| 1497229439 | Laura Marozzi | Lactation Consultant, Non-RN | 7 Summer Pl, Cherry Hill, NJ 08003 | 2019-01-12 |
| 1104328319 | Amanda Butto | Counselor | 1930 Marlton Pike E Ste T, Cherry Hill, NJ 08003 | 2018-03-03 |
| 1073043857 | Sara Cox | Behavioral Analyst | 425 Old Orchard Road, Cherry Hill, NJ 08003 | 2017-06-14 |
| 1912433731 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 527 Balsam Rd, Cherry Hill, NJ 08003 | 2017-05-11 |
| 1366978181 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 102 Evans Lane, Cherry Hill, NJ 08003 | 2017-05-11 |
| Find all providers in zip 08003 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457812729 | Ivia Health LLC | Pharmacy | 828 N Olden Ave Ste 3, Trenton, NJ 08638-4902 | 2019-03-28 |
| 1245705995 | Pharmaplus Infusion LLC | Pharmacy | 10 S New Prospect Rd Unit 6, Jackson, NJ 08527-1651 | 2018-10-09 |
| 1033696505 | Linwood Rx LLC | Pharmacy | 55 Mill St Ste 7, Newton, NJ 07860-1457 | 2018-07-26 |
| 1972058535 | Jenev Enterprises LLC | Pharmacy | 477 State Route 10 Unit 13, Randolph, NJ 07869-2142 | 2016-08-23 |
| 1033560917 | St Maria Pharmacy | Pharmacy | 1093 Ave C, Bayonne, NJ 07002 | 2016-06-22 |
| 1669861761 | London Private LLC | Pharmacy | 989 Bloomfield Ave, Glen Ridge, NJ 07028-1301 | 2015-01-13 |
| 1770981961 | Red Bank Family Pharmacy Inc | Pharmacy | 141 Broad St, Red Bank, NJ 07701-1923 | 2014-12-20 |
| 1881932093 | H & A LLC | Pharmacy | 3712 Park Ave, Weehawken, NJ 07086-6033 | 2013-01-23 |
| 1518227347 | Pompton Pharmacy Corporation | Pharmacy | 720 Hamburg Tpke, Pompton Lakes, NJ 07442-1434 | 2012-05-27 |
| 1285919571 | Jolins Pharmacy | Pharmacy | 412 Sicklerville Rd Ste 103, Sicklerville, NJ 08081-2557 | 2011-10-18 |
| Find all providers with the same taxonomy | ||||
| City | CHERRY HILL |
| Zip Code | 08003 |
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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.