Organization
DELSEA DRIVE 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
1255 W LANDIS AVE, VINELAND, NJ 08360-3423
(856) 794-2989
(856) 794-1910
Mailing address
1255 W LANDIS AVE, VINELAND, NJ 08360-3423
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
RS005755
NJ
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3131947
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
8082707
—
NJ
Enumeration date
08/20/2006
Last updated
06/21/2013
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