Provider Demographics
NPI:1134263346
Name:CEAS PHARMACY INC
Entity type:Organization
Organization Name:CEAS PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:609-345-5105
Mailing Address - Street 1:2838 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401-6326
Mailing Address - Country:US
Mailing Address - Phone:609-345-5105
Mailing Address - Fax:609-345-8892
Practice Address - Street 1:2838 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-6326
Practice Address - Country:US
Practice Address - Phone:609-345-5105
Practice Address - Fax:609-345-8892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS004293003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3125576OtherNABP NUMBER
NJ4350600Medicaid
NJ4350600Medicaid