Organization
CENTER SQUARE SUPERMARKET, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
382 EGG HARBOR RD, SEWELL, NJ 08080-1857
(856) 582-3961
Mailing address
382 EGG HARBOR RD, SEWELL, NJ 08080-1857
(856) 582-3961
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3193757
NCPDP
NJ
Enumeration date
08/14/2006
Last updated
03/30/2010
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