Provider Demographics
NPI:1528398393
Name:PRESCRIPTION CORPORATION OF AMERICA
Entity Type:Organization
Organization Name:PRESCRIPTION CORPORATION OF AMERICA
Other - Org Name:PRESCRIPTION CORPORATION OF AMERICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIORDANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-983-6300
Mailing Address - Street 1:66 FORD RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-1379
Mailing Address - Country:US
Mailing Address - Phone:973-983-6300
Mailing Address - Fax:973-983-5684
Practice Address - Street 1:66 FORD RD STE 230
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-1300
Practice Address - Country:US
Practice Address - Phone:973-983-6300
Practice Address - Fax:973-983-5684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-30
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00701300333600000X
3336C0003X, 3336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0323942Medicaid
3196777OtherNCPDP PROVIDER IDENTIFICATION NUMBER
NJ0323942Medicaid