# EVESHAM SUPERMARKET LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Shop Rite Pharmacy Dept \#529
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427248665
- **Authorized official:** MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
- **Authorized official phone:** (732) 521-8439

## Contact information

- **Practice address:** 400 EVESHAM RD, CHERRY HILL, NJ 08003-4010
- **Practice address phone:** (856) 216-0115
- **Practice address fax:** (856) 216-7190
- **Mailing address:** PO BOX 15169, NEWARK, NJ 07192-5169
- **Mailing address phone:** (856) 216-0115

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 28RS00673500 | NJ | Yes |

## Other

- **Enumeration date:** 07/25/2007
- **Last updated:** 09/19/2025