Organization Active NPI

Cherrywood Plaza Supermarket LLC

Doing business as Shoprite Pharmacy Dept #586

  • Community/Retail Pharmacy
  • Clementon, NJ
National Provider Identifier
1528948916
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
CHERRYWOOD PLAZA SUPERMARKET LLC
Doing business as
Shoprite Pharmacy Dept #586
Practice address
1468 Blackwood Clementon Rd
Clementon, NJ 08021-5778
Phone
(856) 627-0088
Fax
(856) 782-0968
NPI assigned
Sep 5, 2025
Last updated
Oct 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stacy Aurand
Title
Corporate Controller
Phone
(856) 627-6501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1468 Blackwood Clementon Rd
Clementon, NJ 08021-5778

Mailing address

1230 Blackwood Clementon Rd
Clementon, NJ 08021-5632

Other names 1

  • Shoprite Pharmacy Dept #586 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20260113002829 NJ Part B Supplier - Pharmacy 2264918804 Practice locations: Clementon, NJ
O20260113002914 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 2264918804 Practice locations: Clementon, NJ

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1490 Blackwood Clementon Rd
Clementon, NJ 08021

1468 Blackwood Clementon Rd
Laurel Spgs, NJ 08021
Phone (856) 627-0088

NPI Registry JSON

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

{
    "created_epoch": "1757030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759363200000",
    "number": "1528948916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 BLACKWOOD CLEMENTON RD",
            "city": "CLEMENTON",
            "state": "NJ",
            "postal_code": "080215632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 BLACKWOOD CLEMENTON RD",
            "city": "CLEMENTON",
            "state": "NJ",
            "postal_code": "080215778",
            "telephone_number": "856-627-0088",
            "fax_number": "856-782-0968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERRYWOOD PLAZA SUPERMARKET LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-05",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A",
        "authorized_official_last_name": "AURAND",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "CORPORATE CONTROLLER",
        "authorized_official_telephone_number": "856-627-6501"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoprite Pharmacy Dept #586",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clementon, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.