Provider Demographics
NPI:1730504002
Name:BIOLOGICTX LLC
Entity type:Organization
Organization Name:BIOLOGICTX LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO, PRESIDENT, LLC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHEE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KRAMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:549-385-7322
Mailing Address - Street 1:40D COMMERCE WAY
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-3109
Mailing Address - Country:US
Mailing Address - Phone:973-774-0954
Mailing Address - Fax:877-567-8089
Practice Address - Street 1:40D COMMERCE WAY
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-3109
Practice Address - Country:US
Practice Address - Phone:973-774-0954
Practice Address - Fax:877-567-8089
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIOMATRIX SPECIALTY PHARMACY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-24
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS007177003336C0003X, 3336C0003X
333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0390054Medicaid
2144496OtherPK
2144496OtherPK