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Provider Information for 1013673805


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SUGARRX INC

Organization Subpart: NO

NPI: 1013673805
Last Updated: 2022-05-16
Certification Date: 2022-05-16

Details

NameValue
NPI1013673805
Enumeration Date2021-11-16
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: Dr. GABRIELA BERNAT
Title: PRESIDENT
Phone: 2018676705
Mailing Address 4207 BERGENLINE AVENUE
UNION CITY, NJ 07087
United States

Phone: 201-867-6705 | Fax:201-867-3758
 
Primary Practice Address 4207 BERGENLINE AVENUE
UNION CITY, NJ 07087
United States

Phone: 201-867-6705 | Fax:201-867-3758
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDNJ0828572
Other (non-Medicare)NJ2056801PK
Other (non-Medicare)NJ3914550001MEDICARE NSC
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 333600000X - Pharmacy
Yes 3336C0003X - Pharmacy - Community/Retail Pharmacy