Organization
HARBISON SUPERMARKETS LLC
Active
Other names
Shoprite Pharmacy Dept #495
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA-RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
5597 TULIP ST BLDG A, PHILADELPHIA, PA 19124-1562
(215) 288-1947
(856) 357-9304
Mailing address
PO BOX 15169, NEWARK, NJ 07192-5169
(856) 357-9302
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP482771
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1034729480001
—
PA
01
—
2175339
PK
—
Enumeration date
11/15/2017
Last updated
09/19/2025
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