Organization
KEARNY SHOP-RITE INC
Active
Other names
SHOPRITE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA-RIVERA (THIRD PARTY ADMINISTRATOR)
(372) 521-8439
Entity
Organization
Contact information
Practice address
100 PASSAIC AVE, KEARNY, NJ 07032-1140
(201) 991-3568
(201) 991-4272
Mailing address
PO BOX 15169, NEWARK, NJ 07192-5169
(201) 991-3568
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00239800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2054505
PK
—
05
—
4279603
—
NJ
Enumeration date
08/20/2006
Last updated
12/19/2014
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