Organization
SHOPRITE PHARMACY 145
Active
Other names
SHOPRITE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MONA GADKARI (THIRD PARTY ADMINISTRATOR)
(732) 521-8448
Entity
Organization
Contact information
Practice address
2424 HYLAN BLVD, STATEN ISLAND, NY 10306-3117
(718) 979-0718
(718) 979-5462
Mailing address
355 DAVIDSONS MILL RD, JAMESBURG, NJ 08831-3014
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
24150
NY
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01912629
—
NY
01
—
3301645
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/20/2006
Last updated
09/11/2025
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