Provider Demographics
NPI:1508960568
Name:HEALTH CARE PHARMACY INC
Entity Type:Organization
Organization Name:HEALTH CARE PHARMACY INC
Other - Org Name:HEALTH CARE PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GORDIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NDUBIZU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-275-1904
Mailing Address - Street 1:PO BOX 91
Mailing Address - Street 2:
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-0091
Mailing Address - Country:US
Mailing Address - Phone:609-695-3525
Mailing Address - Fax:
Practice Address - Street 1:225 E STATE ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08608-1800
Practice Address - Country:US
Practice Address - Phone:609-695-3525
Practice Address - Fax:609-695-7077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS005495003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7370300Medicaid
2053852OtherPK