Organization
PATCHOGUE SUPERMARKETS LLC
Active
Other names
Patchogue Supermarkets LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
95 SUNRISE HWY W, PATCHOGUE, NY 11772-1847
(631) 286-5030
(631) 286-5031
Mailing address
P.O. BOX 15169, NEWARK, NJ 07192
(631) 286-5030
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
030921
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03395631
—
NY
01
—
2132354
PK
—
Enumeration date
06/06/2011
Last updated
09/19/2025
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