Provider Demographics
NPI:1255762894
Name:LSC PHARMACY SERVICES, INC.
Entity type:Organization
Organization Name:LSC PHARMACY SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AVP
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:VOELKEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:973-322-2946
Mailing Address - Street 1:94 OLD SHORT HILLS RD - EAST WING - CMMC
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039
Mailing Address - Country:US
Mailing Address - Phone:973-322-2946
Mailing Address - Fax:973-322-2419
Practice Address - Street 1:1 CLARA MAASS DR
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-3550
Practice Address - Country:US
Practice Address - Phone:973-450-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIVINGSTON SERVICES CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-09
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RS00731300OtherNJBOP
NJ0565628Medicaid