Provider Demographics
NPI:1710165071
Name:EMC PHARMACY INC
Entity Type:Organization
Organization Name:EMC PHARMACY INC
Other - Org Name:EMC PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANG
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:RASPANTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-565-9150
Mailing Address - Street 1:242 ASTOR ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07114-2616
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:242 ASTOR ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07114-2616
Practice Address - Country:US
Practice Address - Phone:973-565-9150
Practice Address - Fax:973-565-9147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336L0003X, 3336S0011X
NJ28RS006780003336M0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3194925OtherOTHER ID NUMBER