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NPI Code Detail

MEDICARE: ACME MARKETS INC

MEDICARE: ACME MARKETS INC
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
1332B00000XDurable Medical Equipment & Medical Supplies
23336C0003XCommunity/Retail Pharmacy28RS00325300NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760992119
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACME MARKETS INC
Provider Business Mailing Address
First Line : 250 E PARKCENTER BLVD
Second Line :
City : BOISE
State : ID
Zip : 83706-3940
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4100 PARK AVE
Second Line :
City : WEEHAWKEN
State : NJ
Zip : 07086-6196
Country : US
Telephone Number : 201-583-6860
Fax Number : 201-583-6868
Authorized Official
Title or Position : PHARMACY ENROLLMENT SPECIALIST
Name : SUNNY YOST
Credential :
Telephone Number : 208-395-3920
Provider Enumeration Date : 10/11/2017
Last Update Date : 10/11/2017

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Directions to “ACME MARKETS INC ” Practice Location

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