NPIMap

Organization Active NPI

Village Super Market of NJ LP

Doing business as ShopRite Pharmacy of Essex Green

  • Community/Retail Pharmacy
  • West Orange, NJ
National Provider Identifier
1174663371
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
RS002672 Issued in NJ
Legal business name
VILLAGE SUPER MARKET OF NJ LP
Doing business as
ShopRite Pharmacy of Essex Green
Practice address
1 Rooney Cir
West Orange, NJ 07052-3304
Phone
(973) 325-2136
Fax
(973) 736-3487
NPI assigned
Feb 7, 2007
Last updated
Oct 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2011

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) 521-8448

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X RS002672 NJ Primary

Addresses

Primary practice location

1 Rooney Cir
West Orange, NJ 07052-3304

Mailing address

1 Rooney Cir
West Orange, NJ 07052-3304
Phone (973) 325-2136

Other identifiers 2

IdentifierTypeStateIssuer
3121237OtherNJNCPDP
4318005MedicaidNJ

Other names 1

  • ShopRite Pharmacy of Essex Green Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930041147 NJ DME Supplier - Pharmacy 3779604970 Practice locations: West Orange, NJ
O20111111000319 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 3779604970 22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Washington, NJ; West Orange, NJ; Vineland, NJ; Union, NJ; Stirling, NJ; Somerset, NJ; Somers Point, NJ; Rio Grande, NJ…

Other NPIs with the same Medicare PAC ID 18

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

View all 18

Other NPIs on the same Medicare enrollment 22

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

View all 22

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
Village Super Market of NJ LP1 Rooney Cir, West Orange, NJ 07052-3304(973) 325-2136 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Aug 11, 2011

National Provider Directory

National Provider Directory
Tax ID family
Shakoor Supermarkets Inc17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Locations

733 Mountain Ave
Springfield, NJ 07081
Phone (732) 207-1689

1 Rooney Cir
West Orange, NJ 07052
Phone (973) 325-2136

Practitioners & affiliated clinicians

Practitioners 2

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": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318550400000",
    "number": "1174663371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ROONEY CIR",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070523304",
            "telephone_number": "973-325-2136",
            "fax_number": "973-736-3487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROONEY CIR",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070523304",
            "telephone_number": "973-325-2136",
            "fax_number": "973-736-3487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE SUPER MARKET OF NJ LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2011-10-14",
        "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": "732-521-8448"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "RS002672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3121237",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4318005",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ShopRite Pharmacy of Essex Green",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; 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.