Provider Demographics
NPI:1730102732
Name:BAKER PHARMACY INC.
Entity Type:Organization
Organization Name:BAKER PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SREENIVAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BHAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-875-4141
Mailing Address - Street 1:38-42 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:NJ
Mailing Address - Zip Code:07461-2331
Mailing Address - Country:US
Mailing Address - Phone:973-875-4141
Mailing Address - Fax:973-875-0529
Practice Address - Street 1:38-42 MAIN ST
Practice Address - Street 2:
Practice Address - City:SUSSEX
Practice Address - State:NJ
Practice Address - Zip Code:07461-2331
Practice Address - Country:US
Practice Address - Phone:973-875-4141
Practice Address - Fax:973-875-0529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4294602Medicaid
NJ2693500Medicaid
NJ2693500Medicaid