Organization
GATEWAY SHOPRITE ASSOCIATES LLC
Active
Other names
ShopRite Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
590 GATEWAY DR, BROOKLYN, NY 11239-2820
(718) 647-1546
(718) 348-6180
Mailing address
PO BOX 15969, NEWARK, NJ 07192-0001
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
032983
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146300
PK
—
Enumeration date
05/16/2014
Last updated
11/25/2014
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