Organization
VILLAGE SUPER MARKET OF NJ LP
Active
Other names
ShopRite Pharmacy of Rio Grande
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8448
Entity
Organization
Contact information
Practice address
1700 ROUTE 47 SOUTH, RIO GRANDE, NJ 08242-1326
(609) 886-0124
(609) 889-0219
Mailing address
733 MOUNTAIN AVE, SPRINGFIELD, NJ 07081-3223
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
RS004543
NJ
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3132507
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
4533607
—
NJ
Enumeration date
08/20/2006
Last updated
01/24/2012
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