Provider Demographics
NPI:1376715912
Name:OHENE PHARMACY LLC
Entity Type:Organization
Organization Name:OHENE PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:EFFAH
Authorized Official - Last Name:OKAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-622-4500
Mailing Address - Street 1:393-395 SOUTH ORANGE AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103
Mailing Address - Country:US
Mailing Address - Phone:973-622-4500
Mailing Address - Fax:973-622-4504
Practice Address - Street 1:393-395 SOUTH ORANGE AVENUE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103
Practice Address - Country:US
Practice Address - Phone:973-622-4500
Practice Address - Fax:973-622-4504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00638300302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0038628Medicaid
NJ3146126OtherNAPB