Organization
ROCKAWAY SHOPRITE ASSOCIATES INC
Active
Other names
SHOPRITE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEORA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8448
Entity
Organization
Contact information
Practice address
437 ROUTE 46, DOVER, NJ 07801
(973) 366-0402
(973) 366-2383
Mailing address
PO BOX 15169, NEWARK, NJ 07192-5169
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00437400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3125172
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
4346904
—
NJ
01
—
4346912
MEDICAID DME
NJ
Enumeration date
08/20/2006
Last updated
09/19/2018
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