Organization
SHOPRITE PHARMACY
Active
Other names
SHOPRITE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEORA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
26 N MIDDLETOWN RD, PEARL RIVER, NY 10965-2014
(845) 735-4868
(845) 735-4785
Mailing address
PO BOX 15169, NEWARK, NJ 07192-5169
(845) 735-4868
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
017400
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00693389
—
NY
01
—
2061301
PK
—
Enumeration date
08/20/2006
Last updated
07/19/2018
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