Provider Demographics
NPI:1154599066
Name:ALERAN HOLDINGS LLC
Entity type:Organization
Organization Name:ALERAN HOLDINGS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-992-2121
Mailing Address - Street 1:365 E NORTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4810
Mailing Address - Country:US
Mailing Address - Phone:973-992-2121
Mailing Address - Fax:973-992-2123
Practice Address - Street 1:365 E NORTHFIELD RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4810
Practice Address - Country:US
Practice Address - Phone:973-992-2121
Practice Address - Fax:973-992-2123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
NJ28RS006797003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3194963OtherNCPDP
NJ0167851Medicaid
NJFT0785696OtherDEA
NJ6112620001Medicare NSC
NJ3194963OtherNCPDP