Healthcare Provider Details

I. General information

NPI: 1609706456
Provider Name (Legal Business Name): NPC PHARMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1164 E JERSEY ST
ELIZABETH NJ
07201-2311
US

IV. Provider business mailing address

1164 E JERSEY ST
ELIZABETH NJ
07201-2311
US

V. Phone/Fax

Practice location:
  • Phone: 908-994-1525
  • Fax: 908-994-1508
Mailing address:
  • Phone: 908-994-1525
  • Fax: 908-994-1508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL MODZELEWSKI
Title or Position: SUPERVISING PHARMACIST/MEMBER
Credential:
Phone: 908-994-1525