NPIMap

Organization Active NPI

Berat Corporation

Doing business as Shoprite Pharmacy #539

  • Pharmacy
  • Clementon, NJ
National Provider Identifier
1215042098
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
RS003381 Issued in NJ
Legal business name
BERAT CORPORATION
Doing business as
Shoprite Pharmacy #539
Practice address
1224 Blackwood Clementon Rd
Clementon, NJ 08021-5632
Phone
(856) 627-0088
Fax
(856) 782-0968
NPI assigned
Aug 20, 2006
Last updated
Sep 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 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 RS003381 NJ Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

1224 Blackwood Clementon Rd
Clementon, NJ 08021-5632

Mailing address

1230 Blackwood Clementon Rd
Clementon, NJ 08021-5632

Other identifiers 2

IdentifierTypeStateIssuer
4346301MedicaidNJ
3125158OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • Shoprite Pharmacy #539 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100929000654 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 7012033855 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clementon, NJ; Woodbury Heights, NJ; Williamstown, NJ; West Berlin, NJ; Glassboro, NJ

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1224 Blackwood Clementon Rd
Clementon, NJ 08021
Phone (856) 627-0022

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": "1285632000000",
    "number": "1215042098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 BLACKWOOD CLEMENTON RD",
            "city": "CLEMENTON",
            "state": "NJ",
            "postal_code": "080215632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 BLACKWOOD CLEMENTON RD",
            "city": "CLEMENTON",
            "state": "NJ",
            "postal_code": "080215632",
            "telephone_number": "856-627-0088",
            "fax_number": "856-782-0968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERAT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2010-09-28",
        "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": "RS003381",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4346301",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3125158",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoprite Pharmacy #539",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clementon, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.