Active NPI
Five Star Supermarkets of Clinton LLC
- Community/Retail Pharmacy
- Clinton, CT
National Provider Identifier
1487977419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PCY0002169
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2124371 | Other | PK | |
| 008022672 | Medicaid | CT |
Other names 1
- Shoprite Pharmacy
National Provider Directory
National Provider DirectoryNPI 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.