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
3147 KENNEDY BLVD, NORTH BERGEN, NJ 07047-2379
(201) 865-7050
(201) 553-9613
Mailing address
PO BOX 8500-51250, PHILADELPHIA, PA 19178-0001
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
RS005803
NJ
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3141671
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
8090408
—
NJ
01
—
8090416
MEDICAID DME
NJ
Enumeration date
08/20/2006
Last updated
11/22/2010
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