Shoprite of Bristol LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PCY1700 Issued in CT

Legal business name

SHOPRITE OF BRISTOL LLC

Practice address

1200 Farmington Ave
Bristol, CT 06010-4714

Phone

(860) 584-5733

Fax

(860) 584-9668

NPI assigned

Feb 8, 2007

Last updated

Oct 3, 2012By the provider in NPPES

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 2

Addresses

Other identifiers 2

Locations

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.

• Cathleen Gallo, RPH

  • Pharmacist
  • Bristol, CT
  • NPI 1043627789
  NPD (past)

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349222400000",
    "number": "1427198316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 FARMINGTON AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104714",
            "telephone_number": "860-584-5733",
            "fax_number": "860-584-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 FARMINGTON AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104714",
            "telephone_number": "860-584-5733",
            "fax_number": "860-584-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPRITE OF BRISTOL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2012-10-03",
        "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": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "PCY1700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004195956",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0718140",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kenitra Lachelle Sherman, APRN
• Radhee Sheth
• Steven Harold Shmurak, PH.D.
• Prem Shrestha
• Stacey Sifodaskalakis, RPH
• Regina Silk, PHARM D
• Simple Home Care Solutions, LLC
• Terrianne Simpson

• Community/Retail Pharmacy in Bristol, CT
• Providers in Bristol, CT by specialty
• Community/Retail Pharmacy in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.