Organization
KTM II SUPERMARKETS LLC
Active
Other names
Shoprite Pharmacy of Hatfield
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
170 FORTY FOOT RD, HATFIELD, PA 19440-2852
(215) 368-9323
(215) 368-9325
Mailing address
PO BOX 15169, NEWARK, NJ 07192-5169
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP482205
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1026605040001
—
PA
01
—
2131817
PK
—
Enumeration date
07/25/2011
Last updated
11/16/2015
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