Waverly Markets, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PCY1083 Issued in CT

Legal business name

WAVERLY MARKETS, LLC

Doing business as

ShopRite of Manchester/ ShopRite Pharmacy

Practice address

214 Spencer St
Manchester, CT 06040-4618

Phone

(860) 645-3244

Fax

(860) 643-9283

NPI assigned

Feb 8, 2007

Organization subpart

No

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

Addresses

Other identifiers 2

Other names 1

• ShopRite of Manchester/ ShopRite Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CT2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

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

• Jennifer Moffa, P.D.

  • Pharmacist
  • Manchester, CT
  • NPI 1568453819
  NPD (past)
• Catherine Webb

  • Pharmacist
  • Manchester, CT
  • NPI 1376025270
  NPD (past)

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349222400000",
    "number": "1083754980",
    "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": "860-645-3240",
            "fax_number": "860-645-3248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 SPENCER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404618",
            "telephone_number": "860-645-3244",
            "fax_number": "860-643-9283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVERLY MARKETS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2012-10-03",
        "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": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "PCY1083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0708391",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004194635",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ShopRite of Manchester/ ShopRite Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberley Anne Waskowitz, CRNA
• Charles Samuel Wasserman, AU.D.
• Michael W Waters
• Alisha Watson
• Larry A Watts
• Catherine Webb
• Kristine Lynn Webb, LPC
• Brittany Webber
• Donna C Webber, APRN
• Emily M Welch

• Community/Retail Pharmacy in Manchester, CT
• Providers in Manchester, CT by specialty
• Community/Retail Pharmacy in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.