Organization
LML SUPERMARKETS INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
583 AVENUE C, BAYONNE, NJ 07002-3881
(201) 437-5898
(201) 339-1862
Mailing address
583 AVENUE C, BAYONNE, NJ 07002-3881
(201) 437-5898
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
RS004970
NJ
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0252387
—
NJ
01
—
0252671
MEDICAID DME
NJ
01
—
3136199
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/20/2006
Last updated
02/16/2011
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