Provider Demographics
NPI:1700965779
Name:ABELS PHARMACY INC
Entity Type:Organization
Organization Name:ABELS PHARMACY INC
Other - Org Name:ABELS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-595-5656
Mailing Address - Street 1:357 TOTOWA AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07502-2125
Mailing Address - Country:US
Mailing Address - Phone:973-595-5656
Mailing Address - Fax:973-595-0352
Practice Address - Street 1:357 TOTOWA AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07502-2125
Practice Address - Country:US
Practice Address - Phone:973-595-5656
Practice Address - Fax:973-595-0352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00483600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7670605Medicaid
NJ7670605Medicaid