BIOLOGICTX LLC

Provider Demographics

• NPI: 1245503648
• Name: BIOLOGICTX LLC
• Entity type: Organization
• Organization Name: BIOLOGICTX LLC
• Other - Org Name: <UNAVAIL>
• Authorized Official - Title/Position: PRESIDENT
• Authorized Official - First Name: KATHEE
• Authorized Official - Middle Name: M
• Authorized Official - Last Name: KRAMM
• Authorized Official - Phone: 954-385-7322
• Mailing Address - Street 1: 40D COMMERCE WAY
• Mailing Address - City: TOTOWA
• Mailing Address - State: NJ
• Mailing Address - Zip Code: 07512-3109
• Mailing Address - Country: US
• Mailing Address - Phone: 973-774-0954
• Mailing Address - Fax: 973-774-0993
• Practice Address - Street 1: 40D COMMERCE WAY
• Practice Address - City: TOTOWA
• Practice Address - State: NJ
• Practice Address - Zip Code: 07512
• Practice Address - Country: US
• Practice Address - Phone: 973-774-0954
• Practice Address - Fax: 973-774-0993
• EIN: <UNAVAIL>
• Is Organization Subpart?: Yes
• Parent Organization LBN: BIOMATRIX SPECIALTY PHARMACY, LLC
• Parent Organization TIN: <UNAVAIL>
• Enumeration Date: 2012-02-15
• Last Update Date: 2024-12-20

Provider Licenses

State	License ID	Taxonomies
NJ	28RS00717700	3336H0001X
KS	22-102081	3336H0001X
IL	054.019703	3336H0001X
LA	PHY.007314-NR	3336H0001X
IA	4094	3336H0001X
MD	P06938	3336H0001X
DC	NRX0001034	3336H0001X
ID	44904MS	3336H0001X
ME	MO40002123	3336H0001X
IN	64002280A	3336H0001X
FL	PH-26231	3336H0001X
HI	PMP-786	3336H0001X
DE	A9-0001785	3336H0001X
GA	PHNR000488	3336H0001X
AK	107974	3336H0001X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	3336H0001X	Suppliers	Pharmacy	Home Infusion Therapy Pharmacy

Provider Identifiers

State	Identifier ID	ID Type	Issuer
OH	0149231	Medicaid
TN	Q073758	Medicaid
MI	1245503648	Medicaid
NJ	0390054	Medicaid
PA	102990967	Medicaid
WA	2038496	Medicaid
NY	4109404	Medicaid
	2134111	Other	PK
NH	3088440	Medicaid
TX	3539496	Medicaid
	2134111	Other	PK