Provider Demographics
NPI:1538998687
Name:HACKENSACK MERIDIAN AMBULATORY CARE, INC.
Entity type:Organization
Organization Name:HACKENSACK MERIDIAN AMBULATORY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR, RETAIL PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:AUDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANEKAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-261-6798
Mailing Address - Street 1:135 HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-1813
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:135 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-1813
Practice Address - Country:US
Practice Address - Phone:848-308-4950
Practice Address - Fax:848-308-4981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy