Provider Demographics
NPI:1841397775
Name:HEALTH FIRST PHARMACY, LLC
Entity Type:Organization
Organization Name:HEALTH FIRST PHARMACY, LLC
Other - Org Name:HEALTH FIRST PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-818-1882
Mailing Address - Street 1:600 ATLANTIC CITY BLVD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08722-4052
Mailing Address - Country:US
Mailing Address - Phone:732-818-1882
Mailing Address - Fax:732-818-9393
Practice Address - Street 1:600 ATLANTIC CITY BLVD
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08722-4052
Practice Address - Country:US
Practice Address - Phone:732-818-1882
Practice Address - Fax:732-818-9393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS006491003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0073636Medicaid
2055548OtherPK
5535480001Medicare NSC