Organization
MEDFORD SHOPRITE, INC.
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
208 ROUTE 70, MEDFORD, NJ 08055-9522
(609) 953-4723
(609) 953-4733
Mailing address
1230 BLACKWOOD CLEMENTON RD, CLEMENTON, NJ 08021-5632
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
RS005686
NJ
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3140578
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
7845405
—
NJ
Enumeration date
08/20/2006
Last updated
05/13/2010
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