Provider Demographics
NPI:1629013800
Name:CHRONIC CARE PHARMACEUTICAL SERVICES LLC
Entity Type:Organization
Organization Name:CHRONIC CARE PHARMACEUTICAL SERVICES LLC
Other - Org Name:SPECIALTY RX PFL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUPNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-241-6337
Mailing Address - Street 1:2 BERGEN TPKE
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07660-2390
Mailing Address - Country:US
Mailing Address - Phone:908-241-6337
Mailing Address - Fax:908-634-4038
Practice Address - Street 1:33 BRENT LN UNIT 101
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2240
Practice Address - Country:US
Practice Address - Phone:850-952-8100
Practice Address - Fax:850-952-8200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336S0011X
FLPH233653336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2006394OtherPK
FL112209500Medicaid
5649280001Medicare NSC