Provider Demographics
NPI:1962596379
Name:A COPPOLA ASSOCIATES INC
Entity type:Organization
Organization Name:A COPPOLA ASSOCIATES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:COPPOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-398-6066
Mailing Address - Street 1:50 HOPATCHUNG RD
Mailing Address - Street 2:
Mailing Address - City:HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07843-1581
Mailing Address - Country:US
Mailing Address - Phone:973-398-6066
Mailing Address - Fax:
Practice Address - Street 1:50 HOPATCHUNG RD
Practice Address - Street 2:
Practice Address - City:HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07843-1581
Practice Address - Country:US
Practice Address - Phone:973-398-6066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ332B00000X
NJRS05306333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6876501Medicaid
3119143OtherOTHER ID NUMBER-COMMERCIAL NUMBER
NJ6876510Medicaid
NJ6876510Medicaid
NJ6876501Medicaid