MEDICARE: CAPSULE NEW JERSEY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1316585532
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPSULE NEW JERSEY LLC

Provider Business Mailing Address
First Line	:	122 W 146TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10039-3802
Country	:	US
Telephone Number	:	888-685-9515
Fax Number	:	646-934-6409

Provider Business Practice Location Address
First Line	:	41 SPRING ST STE 105
Second Line	:
City	:	NEW PROVIDENCE
State	:	NJ
Zip	:	07974-1143
Country	:	US
Telephone Number	:	201-380-7700
Fax Number	:	646-934-6409

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	ERIC KINARIWALA
Credential	:
Telephone Number	:	888-685-9515

Provider Enumeration Date	:	12/18/2019
Last Update Date	:	09/06/2022

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Directions to “CAPSULE NEW JERSEY LLC ” Practice Location

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