295 CENTRAL AVE LLC — NPI 1811704133 (Licensed & Credentialed Suppliers

CMS-1500 Box 24J / 33a • NPI

1811704133

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

333600000X (CMS 58)

Licensed & Credentialed Suppliers — Pharmacy

Box 32 Service Location & ZIP+4

295 CENTRAL AVE, JERSEY CITY, NJ, 07307-2996

✓ 9-Digit EDI 837 ZIP+4 (07307-2996)

Practice Phone & Referral Fax

(201) 653-1200

Fax: (201) 653-1205

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1811704133 (295 CENTRAL AVE LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1811704133` (NPI-2 Organization / Facility)
Provider / Legal Name	295 CENTRAL AVE LLC
Plain-English Specialty	Licensed & Credentialed Suppliers — Pharmacy NUCC Code: `333600000X` (Pharmacy)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	295 CENTRAL AVE, JERSEY CITY, NJ, 07307-2996
Practice Telephone / Fax	Tel: (201) 653-1200 \| Fax: (201) 653-1205
Administrative Mailing Address	295 CENTRAL AVE, JERSEY CITY, NJ, 07307-2996
Enumeration & Last Sync	Enumerated: 2024-12-11 \| CMS Record Updated: 2024-12-12
Authorized Official	DIPAK SHAH (PIC)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

295 CENTRAL AVE, JERSEY CITY, NJ, 07307-2996

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Plain-English Taxonomy & CMS Crosswalk (333600000X)

What Does Taxonomy Code 333600000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 333600000X translates to:
"Licensed & Credentialed Suppliers — Pharmacy"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 58 (Medical Supply Company with Pharmacist) • CMS Code A5 (Pharmacy)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Pharmacy for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (295 CENTRAL AVE LLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`333600000X` — Pharmacy Plain English: Licensed & Credentialed Suppliers — Pharmacy	State: N/A \| License: `Verified` \| Primary: Yes (Primary)
`3336C0003X` — Pharmacy, Community/Retail Pharmacy Plain English: Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy	State: N/A \| License: `Verified` \| Primary: Secondary
`3336S0011X` — Pharmacy, Specialty Pharmacy Plain English: Licensed & Credentialed Suppliers — Pharmacy, Specialty Pharmacy	State: N/A \| License: `Verified` \| Primary: Secondary

Medical Billing, RCM & Hospital Credentialing Teams:

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295 CENTRAL AVE LLC (NPI #1811704133)