Provider Demographics
NPI:1427323534
Name:APOGEE BIO-PHARM LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:APOGEE BIO-PHARM LIMITED LIABILITY COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:KUBULAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-902-6575
Mailing Address - Street 1:180 RARITAN CENTER PKWY
Mailing Address - Street 2:SUIITE 101
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3630
Mailing Address - Country:US
Mailing Address - Phone:732-902-6575
Mailing Address - Fax:609-534-5693
Practice Address - Street 1:180 RARITAN CENTER PKWY
Practice Address - Street 2:SUIITE 101
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3630
Practice Address - Country:US
Practice Address - Phone:732-902-6575
Practice Address - Fax:609-534-5693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-22
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BN1400X, 332BP3500X, 333600000X, 3336C0004X, 3336H0001X, 3336I0012X, 3336L0003X, 3336M0003X, 3336S0011X
NJ28RS007181003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336M0003XSuppliersPharmacyManaged Care Organization Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2134515OtherPK