Provider Demographics
NPI:1114024049
Name:A PLUS PHARMACY
Entity Type:Organization
Organization Name:A PLUS PHARMACY
Other - Org Name:A PLUS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:BS IN PHARMACY
Authorized Official - Phone:732-308-9099
Mailing Address - Street 1:100 ROUTE 9
Mailing Address - Street 2:UNIT 10
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3014
Mailing Address - Country:US
Mailing Address - Phone:732-308-9099
Mailing Address - Fax:732-308-9007
Practice Address - Street 1:100 ROUTE 9
Practice Address - Street 2:UNIT 10
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3014
Practice Address - Country:US
Practice Address - Phone:732-308-9099
Practice Address - Fax:732-308-9007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS006261003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2055283OtherPK
NJ0003336Medicaid
4880830001Medicare NSC