Organization
VILLAGE SUPER MARKET OF NJ LP
Active
Other names
SHOPRITE PHARMACY OF HAMMONTON
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8448
Entity
Organization
Contact information
Practice address
80 S. WHITE HORSE PIKE SUITE C4, HAMMONTON, NJ 08037
(609) 567-4275
Mailing address
80 S. WHITE HORSE PIKE SUITE C4, HAMMONTON, NJ 08037
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336M0003X
Managed Care Organization Pharmacy
RS006104
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3144223
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
8767106
—
NJ
Enumeration date
08/20/2006
Last updated
10/14/2011
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