Organization
GRADE A MARKET INC
Active
Other names
Grade - A - Market 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
360 CONNECTICUT AVE, NORWALK, CT 06854-1824
(203) 838-5553
(203) 851-5146
Mailing address
PO BOX 15169, NEWARK, NJ 07192-5169
(203) 838-5553
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PCY0001440
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004126232
—
CT
01
—
2000262
PK
—
Enumeration date
02/20/2007
Last updated
12/17/2018
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