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TEXAS ROAD OLD BRIDGE LLC NPI 1003004904


NPI Profile

NPI: 1003004904
Provider Name: TEXAS ROAD OLD BRIDGE LLC

Doing Business As: TEXAS ROAD PHARMACY

Classification:Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 31D2193618

Address:
1183 ENGLISHTOWN RD
OLD BRIDGE, NJ
ZIP 08857
Get Directions

Phone: (732) 723-1101

TEXAS ROAD OLD BRIDGE LLC is a community/retail pharmacy pharmacy in Old Bridge, NJ. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. TEXAS ROAD OLD BRIDGE LLC NPI is 1003004904. The provider is registered as an organization entity type.
The provider Is Doing Business As Texas Road Pharmacy.

The provider's business location address is:

1183 ENGLISHTOWN RD
OLD BRIDGE, NJ
ZIP 08857-319
Phone: (732) 723-1101
Fax: (732) 723-1141

The provider's authorized official is Christopher Socha .
The authorized official title is Secretary Treasurer and has the following contact phone number (732) 723-1101.

The CLIA number assigned to this NPI record is 31D2193618 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/5/2007 and was last updated on 3/11/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336S0011XPharmacySpecialty PharmacyNo
2333600000XPharmacyNo
33336C0003XPharmacyCommunity/Retail Pharmacy28RS00674300NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12056179OTHERPK
20162329MEDICAIDNEW JERSEY
36061970001MEDICARE NSC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 10/10/2021

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