Provider Demographics
NPI:1013673805
Name:SUGARRX INC
Entity type:Organization
Organization Name:SUGARRX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-867-6705
Mailing Address - Street 1:4207 BERGENLINE AVENUE
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087
Mailing Address - Country:US
Mailing Address - Phone:201-867-6705
Mailing Address - Fax:201-867-3758
Practice Address - Street 1:4207 BERGENLINE AVENUE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087
Practice Address - Country:US
Practice Address - Phone:201-867-6705
Practice Address - Fax:201-867-3758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3914550001OtherMEDICARE NSC
NJ2056801OtherPK
NJ0828572Medicaid