# GLB SHOP ASSOCIATES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Shoprite Pharmacy Dept 176
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184739963
- **Authorized official:** MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
- **Authorized official phone:** (732) 521-8439

## Contact information

- **Practice address:** 1409 BROAD ST, BLOOMFIELD, NJ 07003-3001
- **Practice address phone:** (973) 338-4143
- **Practice address fax:** (973) 893-1623
- **Mailing address:** 1409 BROAD ST, BLOOMFIELD, NJ 07003-3001
- **Mailing address phone:** (973) 338-4143
- **Mailing address fax:** (973) 893-1623

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 28RS00571800 | NJ | Yes |

## Other

- **Enumeration date:** 08/20/2006
- **Last updated:** 04/11/2025