Provider Demographics
NPI:1407953334
Name:CHINRAJ SOMERSET LLC
Entity Type:Organization
Organization Name:CHINRAJ SOMERSET LLC
Other - Org Name:SOMERSET PARK PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHINTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-846-6666
Mailing Address - Street 1:900 EASTON AVE STE 26
Mailing Address - Street 2:STE 26
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1760
Mailing Address - Country:US
Mailing Address - Phone:732-846-6666
Mailing Address - Fax:732-214-9476
Practice Address - Street 1:900 EASTON AVE STE 26
Practice Address - Street 2:STE 26
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1760
Practice Address - Country:US
Practice Address - Phone:732-846-6666
Practice Address - Fax:732-214-9476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS000965003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4259203Medicaid
2054422OtherPK
NJ4259203Medicaid