Provider Demographics
NPI:1023374840
Name:PHARMACARE AT NEWARK LLC
Entity type:Organization
Organization Name:PHARMACARE AT NEWARK LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CAITLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BIEMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-377-4678
Mailing Address - Street 1:2701 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-1410
Mailing Address - Country:US
Mailing Address - Phone:443-512-8966
Mailing Address - Fax:443-455-1436
Practice Address - Street 1:825 BROAD ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-2726
Practice Address - Country:US
Practice Address - Phone:410-368-3900
Practice Address - Fax:410-407-4440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS007236003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3198682OtherNCPDP PROVIDER IDENTIFICATION NUMBER