Organization
BROWNS IA LLC
Active
Organization
BROWNS IA LLC
Active
Other names
SHOPRITE PHARMACY OF ISLAND AVE
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
2946 ISLAND AVE, PHILADELPHIA, PA 19153-2026
(215) 937-0327
(215) 492-1835
Mailing address
PO BOX 15169, NEWARK, NJ 07192
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP481371
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010215360001
—
PA
01
—
3983283
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/20/2006
Last updated
07/13/2017
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