Provider Demographics
NPI:1942470430
Name:JAI MAHARAJ RX CORP
Entity Type:Organization
Organization Name:JAI MAHARAJ RX CORP
Other - Org Name:MEDICAP PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RONAK
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-698-2200
Mailing Address - Street 1:912 W BAY AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:BARNEGAT
Mailing Address - State:NJ
Mailing Address - Zip Code:08005
Mailing Address - Country:US
Mailing Address - Phone:609-698-2200
Mailing Address - Fax:609-698-6336
Practice Address - Street 1:912 W BAY AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:BARNEGAT
Practice Address - State:NJ
Practice Address - Zip Code:08005
Practice Address - Country:US
Practice Address - Phone:609-698-2200
Practice Address - Fax:609-698-6336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0181331Medicaid
NJ3195042OtherNCPDP
NJ3195042OtherNCPDP
NJFM0817176OtherDEA #