# INSERRA SUPERMARKET INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750496535
- **Authorized official:** MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
- **Authorized official phone:** (732) 521-8448

## Contact information

- **Practice address:** 540 YORK AVE DELAFIELD RD, LYNDHURST, NJ 07071
- **Practice address phone:** (201) 978-4543
- **Practice address fax:** (201) 372-0695
- **Mailing address:** PO BOX 8500-51250, PHILADELPHIA, PA 19178-0001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | RS004301 | NJ | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/20/2006
- **Last updated:** 08/18/2010