NPIMap

Organization Active NPI

Village Super Market of NJ LP

Doing business as Shoprite Pharmacy of Springfield

  • Pharmacy
  • Springfield, NJ
National Provider Identifier
1306951173
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
RS003147 Issued in NJ
Legal business name
VILLAGE SUPER MARKET OF NJ LP
Doing business as
Shoprite Pharmacy of Springfield
Practice address
727 Morris Tpke
Springfield, NJ 07081-1514
Phone
(973) 467-3162
Fax
(973) 258-1893
NPI assigned
Aug 20, 2006
Last updated
Jul 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X RS003147 NJ Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

727 Morris Tpke
Springfield, NJ 07081-1514

Mailing address

733 Mountain Ave
Springfield, NJ 07081-3223

Other identifiers 2

IdentifierTypeStateIssuer
3117909OtherOTHER ID NUMBER-COMMERCIAL NUMBER
4309308MedicaidNJ

Other names 1

  • Shoprite Pharmacy of Springfield Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 on the same Medicare enrollment 22

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

View all 22

National Provider Directory

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": "1404259200000",
    "number": "1306951173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 MOUNTAIN AVE",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070813223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 MORRIS TPKE",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811514",
            "telephone_number": "973-467-3162",
            "fax_number": "973-258-1893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE SUPER MARKET OF NJ LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2014-07-02",
        "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": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "RS003147",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3117909",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4309308",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoprite Pharmacy of Springfield",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.