Organization Active NPI

LML Supermarkets Incorporated

  • Pharmacy
  • Hackensack, NJ
National Provider Identifier
1003921883
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
RS004994 Issued in NJ
Legal business name
LML SUPERMARKETS INCORPORATED
Practice address
500 S River St
Hackensack, NJ 07601-6651
Phone
(201) 329-7480
Fax
(201) 329-7493
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Melissa Figueroa Rivera
Title
Third Party Administrator
Phone
(732) 521-8439

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X RS004994 NJ Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

500 S River St
Hackensack, NJ 07601-6651

Mailing address

PO Box 781250
Philadelphia, PA 19178-0001

Other identifiers 3

IdentifierTypeStateIssuer
0252344MedicaidNJ
0253421OtherNJMEDICAID DME
3136187OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110921000428 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 1052431491 2 other NPIs on this enrollment
Practice locations: North Bergen, NJ; Palisades Park, NJ; Hackensack, NJ; Bayonne, NJ

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

20 Ridge Rd
Mahwah, NJ 07430
Phone (469) 608-9324

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474329600000",
    "number": "1003921883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781250",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191780001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S RIVER ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016651",
            "telephone_number": "201-329-7480",
            "fax_number": "201-329-7493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LML SUPERMARKETS INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2016-09-20",
        "status": "A",
        "authorized_official_last_name": "FIGUEROA RIVERA",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "THIRD PARTY ADMINISTRATOR",
        "authorized_official_telephone_number": "732-521-8439"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "RS004994",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0252344",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "0253421",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3136187",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.