Provider Demographics
NPI:1417511932
Name:ATMACA LLC
Entity Type:Organization
Organization Name:ATMACA LLC
Other - Org Name:OUR PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAGIHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGCIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-915-5393
Mailing Address - Street 1:665 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-2737
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:665 HIGH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-2737
Practice Address - Country:US
Practice Address - Phone:609-526-4319
Practice Address - Fax:606-526-4981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-30
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0705462Medicaid