Provider Demographics
NPI:1972508877
Name:THRIFTWAY UNION-HILL PHARMACY INC.
Entity Type:Organization
Organization Name:THRIFTWAY UNION-HILL PHARMACY INC.
Other - Org Name:THRIFTWAY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:PERCHUK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-835-2000
Mailing Address - Street 1:324 US HIGHWAY 9 EXCLUSIVE PLAZA
Mailing Address - Street 2:
Mailing Address - City:ENGLISHTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726
Mailing Address - Country:US
Mailing Address - Phone:732-972-2333
Mailing Address - Fax:732-972-5349
Practice Address - Street 1:324 US HIGHWAY 9 EXCLUSIVE PLAZA
Practice Address - Street 2:
Practice Address - City:ENGLISHTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07726
Practice Address - Country:US
Practice Address - Phone:732-972-2333
Practice Address - Fax:732-972-5349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00624400333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8770701Medicaid
NJ5068370001Medicare ID - Type Unspecified