Provider Demographics
NPI:1497760003
Name:CAREPOINT PHARMACY PERTH AMBOY LLC
Entity Type:Organization
Organization Name:CAREPOINT PHARMACY PERTH AMBOY LLC
Other - Org Name:CEDENOS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SNEHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-442-4478
Mailing Address - Street 1:400 STATE ST
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-3486
Mailing Address - Country:US
Mailing Address - Phone:732-442-4478
Mailing Address - Fax:732-442-3376
Practice Address - Street 1:400 STATE ST
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-3486
Practice Address - Country:US
Practice Address - Phone:732-442-4478
Practice Address - Fax:732-442-3376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS005684003336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2160206OtherPK
NJ7853203Medicaid
3114179OtherNCPDP PROVIDER IDENTIFICATION NUMBER