Provider Demographics
NPI:1619592961
Name:APEX LTC PHARMACY LLC
Entity Type:Organization
Organization Name:APEX LTC PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:CHINTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:848-203-5142
Mailing Address - Street 1:5 MISSION DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-2379
Mailing Address - Country:US
Mailing Address - Phone:848-203-5142
Mailing Address - Fax:888-700-3188
Practice Address - Street 1:2650 ROUTE 130 STE D
Practice Address - Street 2:
Practice Address - City:CRANBURY
Practice Address - State:NJ
Practice Address - Zip Code:08512-3327
Practice Address - Country:US
Practice Address - Phone:848-203-5142
Practice Address - Fax:888-700-3188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJPENDINGMedicaid