Organization
SOUTH ORANGE PHARMACY LLC
Active
Other names
South Orange Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER OTTO (OWNER)
(973) 821-5414
Entity
Organization
Contact information
Practice address
73 S ORANGE AVE, SOUTH ORANGE, NJ 07079-1715
(973) 821-5414
(973) 275-5220
Mailing address
73 S ORANGE AVE, SOUTH ORANGE, NJ 07079-1715
(973) 821-5414
(973) 275-5220
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00687000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0193381
—
NJ
01
—
2117729
PK
—
05
—
6227070001
—
NJ
Enumeration date
10/01/2008
Last updated
12/20/2016
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up