Healthcare Provider Details

I. General information

NPI: 1285159152
Provider Name (Legal Business Name): KNIPPERX INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2017
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 PATROL RD STE 100
CHARLESTOWN IN
47111-8670
US

IV. Provider business mailing address

1 HEALTHCARE WAY
LAKEWOOD NJ
08701-5400
US

V. Phone/Fax

Practice location:
  • Phone: 855-647-7379
  • Fax: 855-774-3879
Mailing address:
  • Phone: 732-905-7878
  • Fax: 732-886-9205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number60006622A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number60006622A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number60006622A
License Number StateIN

VIII. Authorized Official

Name: KEVIN BISCH
Title or Position: VP, PHARMACY OPERATIONS
Credential:
Phone: 267-251-6319