Organization
WAVERLY MARKETS OF VERNON LLC
Active
Other names
Shoprite Pharmacy of Vernon
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
35 TALCOTTVILLE RD, VERNON, CT 06066-5261
(860) 872-8961
Mailing address
PO BOX 15169, NEWARK, NJ 07192-5169
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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