Organization
KLEINS AT RIVERSIDE INC
Active
Other names
Klein's Shoprite Pharmacy #551
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
1321 RIVERSIDE PKWY, BELCAMP, MD 21017-1388
(410) 757-6601
(410) 297-2276
Mailing address
1321 RIVERSIDE PKWY, BELCAMP, MD 21017-1388
(410) 757-6601
(410) 297-2276
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P01719
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190692500
—
MD
01
—
2118594
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/24/2006
Last updated
10/08/2012
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