Center Square Plaza Supermarket, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CENTER SQUARE PLAZA SUPERMARKET, LLC

Doing business as

ShopRite Pharmacy Dept. #591

Practice address

65 Center Square Road
Woolwich Township, NJ 08085

Phone

(856) 627-6501

NPI assigned

Oct 17, 2022

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 1

Addresses

Other names 1

• ShopRite Pharmacy Dept. #591 Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ2 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

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666569600000",
    "number": "1306562871",
    "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": "65 CENTER SQUARE ROAD",
            "city": "WOOLWICH TOWNSHIP",
            "state": "NJ",
            "postal_code": "08085",
            "telephone_number": "856-627-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER SQUARE PLAZA SUPERMARKET, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-17",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ShopRite Pharmacy Dept. #591",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ShopRite Pharmacy Dept. #591",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Advoserv of New Jersey, Inc.
• Robert Lee Baerman Jr., M.S., ATC
• Tierra J Brown, MSW, LCSW
• Jaclyn Cammarata, APN
• Jamie Michele Clement, APN
• Joseph Christopher Davis, RPH
• Pritiben B Desai, APN
• Devereux Foundation (Devereux Advanced Behavioral Health)
• Devereux Foundation (Devereux Advanced Behavioral Health)

• Community/Retail Pharmacy in Woolwich Township, NJ
• Providers in Woolwich Township, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.