Provider Demographics
NPI:1831694546
Name:ESSEX RX CARE INC
Entity type:Organization
Organization Name:ESSEX RX CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KHAJA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHATEEB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-368-3333
Mailing Address - Street 1:324-326 ESSEX ST
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644
Mailing Address - Country:US
Mailing Address - Phone:201-368-3333
Mailing Address - Fax:201-368-3334
Practice Address - Street 1:324 ESSEX ST
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:NJ
Practice Address - Zip Code:07644-2702
Practice Address - Country:US
Practice Address - Phone:201-368-3333
Practice Address - Fax:201-368-3334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-26
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS007611003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2176584OtherPK