SOUTH ORANGE PHARMACY – NPI #1861643561
Pharmacy

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

SOUTH ORANGE PHARMACY is a pharmacy located in SOUTH ORANGE, NJ. NPPES has assigned the NPI number 1861643561 to SOUTH ORANGE PHARMACY on October 01, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SOUTH ORANGE PHARMACY” is a dba name, the actual legal business name for this organization is SOUTH ORANGE PHARMACY LLC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 3336C0003X from the Health Care Provider Taxonomy code set, which is classified as Pharmacy, specializing in Community/Retail Pharmacy

The NPI profile was previously updated about 9 years ago on Dec 20, 2016. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SOUTH ORANGE PHARMACY below.

NPI Profile for
SOUTH ORANGE PHARMACY LLC

NPI Number
1861643561
Enumeration Date

(more than 17 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SOUTH ORANGE PHARMACY LLC
Doing Business As (dba): SOUTH ORANGE PHARMACY
Primary location
73 S ORANGE AVE
SOUTH ORANGE, NJ 07079-1715
Phone: (973) 821-5414 Fax: (973) 275-5220
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
CHRISTOPHER OTTO
OWNER
Phone: (973) 821-5414
Updated
Identifiers

Identifiers for SOUTH ORANGE PHARMACY

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERPK2117729
MEDICAIDNJ0193381
MEDICAIDNJ6227070001
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
3336C0003X
- Pharmacy / Community/Retail Pharmacy (Primary)
NJ 28RS00687000
332B00000X
- Durable Medical Equipment & Medical Supplies

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.