Organization
AJS SUPERMARKET 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
367 ROUTE 22, HILLSIDE, NJ 07205-2056
(908) 810-8060
(908) 810-8063
Mailing address
367 ROUTE 22, HILLSIDE, NJ 07205-2056
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00629900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015679
—
NJ
05
—
15679
—
NJ
01
—
3145554
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/20/2006
Last updated
01/16/2012
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