NPIMap

Organization Active NPI

Kleins Tower Plaza Inc

  • Community/Retail Pharmacy
  • Forest Hill, MD
National Provider Identifier
1053428243
Registry record updated Aug 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
P00889 Issued in MD
Legal business name
KLEINS TOWER PLAZA INC
Doing business as
KLEINS Shoprite Pharmacy #545
Practice address
2101 Rock Spring Rd
Forest Hill, MD 21050-2617
Phone
(410) 420-8224
Fax
(410) 420-8228
NPI assigned
Aug 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2009

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
Community/Retail Pharmacy 3336C0003X P00889 MD Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

2101 Rock Spring Rd
Forest Hill, MD 21050-2617

Mailing address

2101 Rock Spring Rd
Forest Hill, MD 21050-2617
Phone (410) 420-8224

Other identifiers 2

IdentifierTypeStateIssuer
2111778OtherNCPDP PROVIDER IDENTIFICATION NUMBER
773192200MedicaidMD

Other names 1

  • KLEINS Shoprite Pharmacy #545 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930052621 MD DME Supplier - PharmacyDME Supplier - Grocery Store 4385763473 Practice locations: Forest Hill, MD
O20110720000329 MD Part B Supplier - Mass Immunization (Roster Biller Only) 4385763473 Practice locations: Forest Hill, MD

National Provider Directory

National Provider Directory
Tax ID family
Kleins Tower Plaza Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251158400000",
    "number": "1053428243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 ROCK SPRING RD",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210502617",
            "telephone_number": "410-420-8224",
            "fax_number": "410-420-8228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 ROCK SPRING RD",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210502617",
            "telephone_number": "410-420-8224",
            "fax_number": "410-420-8228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLEINS TOWER PLAZA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2009-08-25",
        "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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MD",
            "license": "P00889",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2111778",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "773192200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KLEINS Shoprite Pharmacy #545",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Forest Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; 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.