Organization Active NPI

Shoprite Pharmacy

  • Community/Retail Pharmacy
  • Pearl River, NY
National Provider Identifier
1043325822
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
017400 Issued in NY
Legal business name
SHOPRITE PHARMACY
Practice address
26 N Middletown Rd
Pearl River, NY 10965-2014
Phone
(845) 735-4868
Fax
(845) 735-4785
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 017400 NY Primary

Addresses

Primary practice location

26 N Middletown Rd
Pearl River, NY 10965-2014

Mailing address

PO Box 15169
Newark, NJ 07192-5169
Phone (845) 735-4868

Other identifiers 2

IdentifierTypeStateIssuer
2061301OtherPK
00693389MedicaidNY

Other names 1

  • SHOPRITE PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110303000312 NY Part B Supplier - Mass Immunization (Roster Biller Only) 4486773587 Practice locations: Pearl River, NY

National Provider Directory

National Provider Directory

Member of 1

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

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

26 N Middletown Rd
Pearl River, NY 10965
Phone (845) 735-4868

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1531958400000",
    "number": "1043325822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15169",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071925169",
            "telephone_number": "845-735-4868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 N MIDDLETOWN RD",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109652014",
            "telephone_number": "845-735-4868",
            "fax_number": "845-735-4785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPRITE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "FIGUEORA 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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "017400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2061301",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00693389",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHOPRITE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pearl River, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.