Organization
BROWN'S PARKSIDE, LLC
Active
Other names
Shoprite Pharmacy of Parkside
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
1575 N 52ND ST, STE 400, PHILADELPHIA, PA 19131-4736
(215) 220-8800
(215) 220-8888
Mailing address
PO BOX 15169, NEWARK, NJ 07192-5169
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP481826
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3990202
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/14/2008
Last updated
05/04/2011
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