Organization
SHOP RITE OF BELLEVILLE LLC
Active
Other names
Belleville 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
726 WASHINGTON AVE, BELLEVILLE, NJ 07109-2871
(973) 450-0466
Mailing address
PO BOX 15169, NEWARK, NJ 07192-5169
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
28RS00729400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2142001
PK
—
Enumeration date
07/19/2013
Last updated
01/06/2014
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