Provider Demographics
NPI:1962413484
Name:RICHS PHARMACY INC
Entity type:Organization
Organization Name:RICHS PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:POLACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-754-0707
Mailing Address - Street 1:144 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-3407
Mailing Address - Country:US
Mailing Address - Phone:908-754-0707
Mailing Address - Fax:908-754-5241
Practice Address - Street 1:144 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-3407
Practice Address - Country:US
Practice Address - Phone:908-754-0707
Practice Address - Fax:908-754-5241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS003512003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4353609Medicaid
3125829OtherNCPDP PROVIDER IDENTIFICATION NUMBER
3125829OtherNCPDP PROVIDER IDENTIFICATION NUMBER