Provider Demographics
NPI:1295447217
Name:HACKENSACK MERIDIAN AMBULATORY CARE, INC
Entity type:Organization
Organization Name:HACKENSACK MERIDIAN AMBULATORY CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHENK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:732-836-4545
Mailing Address - Street 1:7600 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-6217
Mailing Address - Country:US
Mailing Address - Phone:201-854-6300
Mailing Address - Fax:201-520-1929
Practice Address - Street 1:7600 RIVER RD
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-6217
Practice Address - Country:US
Practice Address - Phone:201-854-6300
Practice Address - Fax:201-520-1929
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HACKENSACK MERIDIAN AMBULATORY CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RS00544100OtherNJ BOARD OF PHARMACY REGRISTRATION