NPIMap

Organization Active NPI

Shoprite Supermarkets, Inc

Doing business as Shoprite Pharmacy of Vailsgate

  • Community/Retail Pharmacy
  • Vails Gate, NY
National Provider Identifier
1053426833
Registry record updated May 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SHOPRITE SUPERMARKETS, INC
Doing business as
Shoprite Pharmacy of Vailsgate
Practice address
Route 32 384 Windsor Hwy
Vails Gate, NY 12584
Phone
(845) 863-1054
Fax
(845) 863-1056
NPI assigned
Aug 20, 2006
Last updated
May 26, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2010

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 005418 NY
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

Route 32 384 Windsor Hwy
Vails Gate, NY 12584

Mailing address

PO Box 29010
New York, NY 10087-9010

Other identifiers 2

IdentifierTypeStateIssuer
3326053OtherOTHER ID NUMBER-COMMERCIAL NUMBER
02146683MedicaidNY

Other names 1

  • SHOPRITE PHARMACY OF VAILSGATE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110110000400 NY Part B Supplier - Mass Immunization (Roster Biller Only) 9436278413 15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Carmel, NY; Hudson, NY; Monticello, NY

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1274832000000",
    "number": "1053426833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29010",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100879010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROUTE 32 384 WINDSOR HWY",
            "city": "VAILS GATE",
            "state": "NY",
            "postal_code": "12584",
            "telephone_number": "845-863-1054",
            "fax_number": "845-863-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPRITE SUPERMARKETS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2010-05-26",
        "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": "NY",
            "license": "005418",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3326053",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02146683",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHOPRITE PHARMACY OF VAILSGATE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vails Gate, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.

Verify at the official NPI Registry.