Provider Demographics
NPI:1073528600
Name:CHINRAJ-BELMAR LLC
Entity Type:Organization
Organization Name:CHINRAJ-BELMAR LLC
Other - Org Name:BELMAR TOWN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHINTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-280-1600
Mailing Address - Street 1:911 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELMAR
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-2723
Mailing Address - Country:US
Mailing Address - Phone:732-280-1600
Mailing Address - Fax:732-280-1666
Practice Address - Street 1:911 MAIN ST
Practice Address - Street 2:
Practice Address - City:BELMAR
Practice Address - State:NJ
Practice Address - Zip Code:07719-2723
Practice Address - Country:US
Practice Address - Phone:732-280-1600
Practice Address - Fax:732-280-1666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS007002003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3193454OtherNCPDP PROVIDER IDENTIFICATION NUMBER