| NPI | 1063760098 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2012-08-23 |
| Last Updated | 2014-01-30 |
| Authorized Official | David Segal owner Phone: 9087451020 |
| Mailing Address | 400 Madison Ave Lakewood, NJ 08701-3225 United States Phone: (732) 370-4200 | Fax: (732) 328-2233 📍 View Map |
| Primary Practice Address | 400 Madison Ave Lakewood, NJ 08701-3225 United States Phone: (732) 370-4200 | Fax: (732) 328-2233 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | NJ | 0366196 | - |
| Other (non-Medicare) | - | 2136670 | PK |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 333600000X – Pharmacy | - | - |
| Yes | 3336C0003X – Pharmacy, Community/Retail Pharmacy | NJ | 28RS00721100 |
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About NPI 1063760098
Madison Ave Pharmacy Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1063760098. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Lakewood, NJ. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2012-08-23. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1063760098?
NPI 1063760098 belongs to Madison Ave Pharmacy Llc, a Pharmacy, Community/Retail Pharmacy in Lakewood, NJ. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1063760098 active?
The current status of NPI 1063760098 in the NPPES registry is Active. The record was last updated on 2014-01-30.
What specialty is NPI 1063760098?
NPI 1063760098 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1063760098?
You can verify NPI 1063760098 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1063760098?
The primary practice address on file for NPI 1063760098 is 400 Madison Ave, Lakewood, NJ 08701-3225. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1063760098 issued?
NPI 1063760098 was first issued (enumerated) on 2012-08-23. The NPPES record was last updated on 2014-01-30.
Practice Location Map
Madison Ave Pharmacy Llc is located at 400 Madison Ave, Lakewood, NJ. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Madison Ave Pharmacy Llc. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1063760098. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pharmacy, Community/Retail Pharmacy | 28RS00721100 | NJ |