Organization
SHOPRITE SUPERMARKETS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
3140 E MAIN ST STE 300, MOHEGAN LAKE, NY 10547
(914) 739-7474
Mailing address
3140 E MAIN ST STE 300, MOHEGAN LAKE, NY 10547-1517
(914) 739-7474
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
025414
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00582701
—
NY
01
—
3326077
NCPDP
NY
Enumeration date
02/06/2007
Last updated
01/16/2019
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