Organization Active NPI

Five Star Supermarkets of Clinton LLC

  • Community/Retail Pharmacy
  • Clinton, CT
National Provider Identifier
1487977419
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PCY0002169 Issued in CT
Legal business name
FIVE STAR SUPERMARKETS OF CLINTON LLC
Practice address
266 E Main St
Clinton, CT 06413-2254
Phone
(860) 669-6619
Fax
(860) 669-1368
NPI assigned
Mar 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PCY0002169 CT Primary

Addresses

Primary practice location

266 E Main St
Clinton, CT 06413-2254

Mailing address

PO Box 15169
Newark, NJ 07192-5169
Phone (860) 669-6619

Other identifiers 2

IdentifierTypeStateIssuer
2124371OtherPK
008022672MedicaidCT

Other names 1

  • Shoprite Pharmacy Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1487977419",
    "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",
            "telephone_number": "860-669-6619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 E MAIN ST",
            "city": "CLINTON",
            "state": "CT",
            "postal_code": "064132254",
            "telephone_number": "860-669-6619",
            "fax_number": "860-669-1368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR SUPERMARKETS OF CLINTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-04",
        "last_updated": "2025-09-19",
        "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "PCY0002169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2124371",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008022672",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoprite Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.