Provider Demographics
NPI:1003913922
Name:CENTURY URBAN PHCY INC
Entity Type:Organization
Organization Name:CENTURY URBAN PHCY INC
Other - Org Name:CENTURY SPECIALTY SCRIPT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-833-2345
Mailing Address - Street 1:121 CEDAR LN
Mailing Address - Street 2:STE 101
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4457
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:121 CEDAR LN
Practice Address - Street 2:STE 101
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4457
Practice Address - Country:US
Practice Address - Phone:201-833-2345
Practice Address - Fax:201-833-2399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X
NJ28RS005992003336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3134676OtherOTHER ID NUMBER
NJ4262000Medicaid
NJ4262000Medicaid