Organization
BROWNS SUPERSTORES INC
Active
Other names
ShopRite Pharmacy of Roxborough 519
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
6901 RIDGE AVE, PHILADELPHIA, PA 19128-3209
(215) 482-7900
(215) 482-4894
Mailing address
355 DAVIDSONS MILL RD, JAMESBURG, NJ 08831-3014
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP481426
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039836581441
—
PA
01
—
3983651
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/20/2006
Last updated
02/16/2012
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