Organization
COLLINS FAMILY MARKETS, INC.
Active
Organization
COLLINS FAMILY MARKETS, INC.
Active
Other names
SHOPRITE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
5675 N FRONT ST, PHILADELPHIA, PA 19120
(215) 224-7505
(215) 224-8329
Mailing address
5675 N FRONT ST, PHILADELPHIA, PA 19120
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP414003L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001112638
—
PA
01
—
259531
MASS IMMUNIZATION PTAN
—
01
—
3955208
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/20/2006
Last updated
01/14/2013
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