NPIMap

Organization Active NPI

Shoprite Supermarkets, Inc

  • Community/Retail Pharmacy
  • Clark, NJ
National Provider Identifier
1124133996
Registry record updated May 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SHOPRITE SUPERMARKETS, INC
Practice address
76 Central Ave
Clark, NJ 07066-1422
Phone
(732) 381-1133
Fax
(732) 381-7191
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 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 RS002521 NJ
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

76 Central Ave
Clark, NJ 07066-1422

Mailing address

PO Box 29010
New York, NY 10087-9010

Other identifiers 2

IdentifierTypeStateIssuer
3118747OtherOTHER ID NUMBER-COMMERCIAL NUMBER
4314107MedicaidNJ

Other names 1

  • SHOPRITE PHARMACY 163 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930090241 NJ DME Supplier - PharmacyDME Supplier - Grocery Store 9436278413 Practice locations: Clark, NJ
O20110921000296 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 9436278413 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Spotswood, NJ; Montague, NJ; Clark, NJ

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

Laboratory certificates & supplier records

Derived by NPIMap

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

SupplierSuppliesMedicare assignment
Shoprite Supermarkets Inc76 Central Ave, Clark, NJ 07066-1492(732) 381-1133 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Oct 1, 2010

National Provider Directory

National Provider Directory
Tax ID family
Shoprite Pharmacy8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274745600000",
    "number": "1124133996",
    "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": "76 CENTRAL AVE",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661422",
            "telephone_number": "732-381-1133",
            "fax_number": "732-381-7191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPRITE SUPERMARKETS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2010-05-25",
        "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": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "RS002521",
            "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": "3118747",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4314107",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHOPRITE PHARMACY 163",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; 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.