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Contact Information

21ST AVE PHARMACY INC.
357 21ST AVE
PATERSON, NJ07501-3642
 Phone: 973-742-1235
 Fax: 973-742-0353
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pharmacist

183500000X
Indicates primary specialty

NPI Profile & details for 21ST AVE PHARMACY INC.

NPI Number 1336124593
LBN Legal business name 21ST AVE PHARMACY INC.
Authorized official ANTONIO RODRIGUEZ - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/09/2005
Last updated 02/19/2009 - About 17 years ago
Identifiers
NJ License # 28RS003348
NJ License # 28RS00334800
NJ Medicaid 0107905
NJ Medicaid 4344600
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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