Active NPI
Inserra Supermarket Incorporated
- Pharmacy
- New Milford, NJ
National Provider Identifier
1033224811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- RS003428
- Legal business name
- INSERRA SUPERMARKET INCORPORATED
- Practice address
- 814 River Rd
New Milford, NJ 07646-3014 - Phone
- (201) 262-8838
- Fax
- (201) 599-1009
- NPI assigned
- Aug 20, 2006
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | RS003428 | NJ | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
814 River Rd
New Milford, NJ 07646-3014
Mailing address
PO Box 8500-51250
Philadelphia, PA 19178-0001
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3125413 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 4348206 | Medicaid | NJ | |
| 4348214 | Other | NJ | MEDICAID DME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111013000093 | NJ | Part B Supplier - Mass Immunization (Roster Biller Only) | 9436276185 |
10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Emerson, NJ; Hillsdale, NJ; Hoboken, NJ; Jersey City, NJ; Lodi, NJ; Lyndhurst, NJ; New Milford, NJ; Northvale, NJ… |
Other NPIs on the same Medicare enrollment 10
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Community/Retail Pharmacy
- Hoboken, NJ
- NPI 1477691244
O20111013000093
-
- Community/Retail Pharmacy
- Lyndhurst, NJ
- NPI 1750496535
O20111013000093
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Member organizations 5
Organizations listed as members of this organization in the National Provider Directory.
Locations
814 River Rd
New Milford, NJ 07646
Phone (201) 262-8838
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": "1282089600000",
"number": "1033224811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8500-51250",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191780001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "814 RIVER RD",
"city": "NEW MILFORD",
"state": "NJ",
"postal_code": "076463014",
"telephone_number": "201-262-8838",
"fax_number": "201-599-1009"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INSERRA SUPERMARKET INCORPORATED",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-20",
"last_updated": "2010-08-18",
"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": "RS003428",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3125413",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4348206",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID DME",
"identifier": "4348214",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Milford, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; 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.