Organization
RACETRACK 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
2230 ROUTE 70 W # 40, CHERRY HILL, NJ 08002-3338
(856) 910-2320
(856) 910-2322
Mailing address
PO BOX 15169, NEWARK, NJ 07192-5169
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00569600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2054068
PK
—
05
—
7845103
—
NJ
Enumeration date
08/20/2006
Last updated
10/11/2017
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