Healthcare Provider Details

I. General information

NPI: 1760207997
Provider Name (Legal Business Name): CLINICARE PHARM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PARK AVE
PLAINFIELD NJ
07060-1636
US

IV. Provider business mailing address

701 PARK AVE
PLAINFIELD NJ
07060-1636
US

V. Phone/Fax

Practice location:
  • Phone: 908-754-1600
  • Fax: 908-756-6270
Mailing address:
  • Phone: 908-754-1600
  • Fax: 908-756-6270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: OLIVER NKWONTA
Title or Position: PRESIDENT
Credential: PHARMD
Phone: 732-991-6128