Organization
FIVE STAR SUPERMARKETS OF NORWICH INC
Active
Other names
Shoprite Pharmacy of Norwich
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
634 W MAIN ST, NORWICH, CT 06360-6007
(860) 859-9758
(860) 859-9789
Mailing address
PO BOX 15169, NEWARK, NJ 07192-5169
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PCY0002261
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139503
PK
—
Enumeration date
02/19/2013
Last updated
02/12/2014
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