Organization
SHOPRITE PHARMACY
Active
Other names
SHOPRITE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEORA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
503 PAULISON AVE, PASSAIC, NJ 07055-3163
(973) 471-7499
(973) 471-0279
Mailing address
PO BOX 15169, NEWARK, NJ 07192-5169
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00652800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0086053
—
NJ
01
—
2055632
PK
—
Enumeration date
08/20/2006
Last updated
05/05/2014
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