Organization
COLLINS MARKETS 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
140 N MACDADE BLVD, GLENOLDEN, PA 19036-1224
(215) 744-0800
Mailing address
PO BOX 15169, NEWARK, NJ 07192-5169
(215) 744-0800
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP482632
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013206150002
—
PA
01
—
2157705
PK
—
Enumeration date
01/22/2016
Last updated
11/15/2016
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