Organization
VILLAGE SUPER MARKET OF NJ LP
Active
Other names
ShopRite Pharmacy of Old Bridge
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
600 SCHULMEISTER RD, OLD BRIDGE, NJ 08857-2966
(732) 727-3534
(732) 727-3031
Mailing address
733 MOUNTAIN AVE, SPRINGFIELD, NJ 07081-3223
(732) 727-3534
(732) 727-3031
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
RS005177
NJ
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0296279
—
NJ
01
—
229731
IMMUNIZATION PTAN
—
01
—
3122734
NCPDP
NJ
Enumeration date
02/02/2007
Last updated
06/25/2025
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