Delsea Drive Supermarket, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

DELSEA DRIVE SUPERMARKET, LLC

Practice address

1255 W Landis Ave
Vineland, NJ 08360-3423

Phone

(856) 794-2989

Fax

(856) 794-1910

NPI assigned

Aug 20, 2006

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

Other names 1

• SHOPRITE PHARMACY 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

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371772800000",
    "number": "1487769261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 W LANDIS AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083603423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 W LANDIS AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083603423",
            "telephone_number": "856-794-2989",
            "fax_number": "856-794-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELSEA DRIVE SUPERMARKET, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2013-06-21",
        "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": "RS005755",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3131947",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8082707",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHOPRITE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Edgardo Deleon, MD
• Ximena Delgadillo Ayala
• William J Deliberis, DPM
• John Michael Delloso Jr., PTA
• Dinuli Hashangani Delpachitra, MD
• Dilek S Delvers, M.D.
• Dendrinos Medical Associates, P.a.
• George Aristidis Dendrinos, M.D.
• Yuyao Deng, M.D.
• Dental Care of Brigantine, LLC

• Community/Retail Pharmacy in Vineland, NJ
• Providers in Vineland, 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 Jun 21, 2013; 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.