Organization
BROWN'S PARKSIDE, LLC
Active
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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