Provider Demographics
NPI:1306987417
Name:RAP-R PHARMACY INC
Entity type:Organization
Organization Name:RAP-R PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMA RAO
Authorized Official - Middle Name:
Authorized Official - Last Name:PALADUGU
Authorized Official - Suffix:
Authorized Official - Credentials:BS PHARMACY
Authorized Official - Phone:201-868-5700
Mailing Address - Street 1:6101 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-3441
Mailing Address - Country:US
Mailing Address - Phone:201-868-5700
Mailing Address - Fax:201-868-5282
Practice Address - Street 1:6101 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-3441
Practice Address - Country:US
Practice Address - Phone:201-868-5700
Practice Address - Fax:201-868-5282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS004696003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RS00469600OtherPHARMACY LICENSE
NJ5222401Medicaid
NJ28RS00469600OtherPHARMACY LICENSE