Mannix Family Market at Veterans Road LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

034048 Issued in NY

Legal business name

MANNIX FAMILY MARKET AT VETERANS ROAD LLC

Doing business as

Shoprite Pharmacy

Practice address

3010 Veterans Rd W
Staten Island, NY 10309-2510

Phone

(718) 979-0718

NPI assigned

Oct 6, 2015

Last updated

Feb 16, 2017By 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 1

Other names 1

• Shoprite Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1477923266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15169",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071925169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 VETERANS RD W",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103092510",
            "telephone_number": "718-979-0718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANNIX FAMILY MARKET AT VETERANS ROAD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-06",
        "last_updated": "2017-02-16",
        "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "034048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154797",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoprite Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christine M. Mannino, M.S.
• Lisa Marie Mannino, OTR/L
• Victoria Mannino
• William Emilio Mannino, FNP-BC
• Mannix Family Market @ Forest and Richmond Ave LLC (Shoprite Pharmacy of Forest and Richmond)
• Namala Luke Manohar, MD
• Michael G Manolios, M.D.
• Manor Dental of Staten Island PC
• Manor Road Physical Therapy PC
• Marseil Mansi

• Community/Retail Pharmacy in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; 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.