Organization
GLASS GARDENS INC
Active
Other names
SHOPRITE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA FIGUEROA RIVERA (THIRD PARTY ADMINISTRATOR)
(732) 521-8439
Entity
Organization
Contact information
Practice address
220 W PASSAIC ST, ROCHELLE PARK, NJ 07662-3118
(201) 843-5572
(201) 843-2145
Mailing address
220 W PASSAIC ST, ROCHELLE PARK, NJ 07662-3118
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00437600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2058052
PK
—
05
—
4362501
—
NJ
Enumeration date
08/20/2006
Last updated
10/20/2014
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