Provider Demographics
NPI:1376618355
Name:LITTLE SILVER FAMILY PHARMACY LLC
Entity Type:Organization
Organization Name:LITTLE SILVER FAMILY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:PARISI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:732-741-1121
Mailing Address - Street 1:10 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-1440
Mailing Address - Country:US
Mailing Address - Phone:732-741-1121
Mailing Address - Fax:732-224-0107
Practice Address - Street 1:10 CHURCH ST
Practice Address - Street 2:
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1440
Practice Address - Country:US
Practice Address - Phone:732-741-1121
Practice Address - Fax:732-224-0107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4470640001332B00000X
NJ28RS005765003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8055203Medicaid
NJ3110993OtherNABP
NJ8055211OtherMEDICAID DME
NJ8055203Medicaid