Provider Demographics
NPI:1114938719
Name:CHEMRX NEW JERSEY
Entity Type:Organization
Organization Name:CHEMRX NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGAL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:908-222-1011
Mailing Address - Street 1:4041 HADLEY RD STE M
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-1111
Mailing Address - Country:US
Mailing Address - Phone:908-222-1011
Mailing Address - Fax:908-222-8877
Practice Address - Street 1:4041 HADLEY RD STE M
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-1111
Practice Address - Country:US
Practice Address - Phone:908-222-1011
Practice Address - Fax:908-222-8877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1114938719332B00000X
NJ282S00663000333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0116971Medicaid
NY02843878Medicaid
NJ5785390001Medicare NSC