Provider Demographics
NPI:1114066966
Name:NATHJI PLUS INC
Entity Type:Organization
Organization Name:NATHJI PLUS INC
Other - Org Name:EASTPARK PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HIREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:609-877-7600
Mailing Address - Street 1:1 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-2537
Mailing Address - Country:US
Mailing Address - Phone:609-877-7600
Mailing Address - Fax:609-877-4540
Practice Address - Street 1:1 ROSE ST
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-2537
Practice Address - Country:US
Practice Address - Phone:609-877-7600
Practice Address - Fax:609-877-4540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02377800183500000X
NJ28RS00649600332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0067423Medicaid
NJ3104003OtherNCPDP NUMBER
NJ0067415Medicaid
NJ0067415Medicaid
NJ3104003OtherNCPDP NUMBER