Shoprite Supermarkets, Inc
Organization Active NPI Community/Retail Pharmacy · Montague, NJ
NPI 1619082492 · NPPES record last updated May 26, 2010
Key facts
- NPI
- 1619082492
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- SHOPRITE SUPERMARKETS, INC
- Practice address
- 10A RT. 23, Tri State Mall
Montague, NJ 07827 - Phone
- (973) 293-3273
- Fax
- (973) 293-7266
- NPI assigned
- Aug 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Melissa Figueroa Rivera
- Title
- Third Party Administrator
- Phone
- (732) 521-8439
Other NPIs on the same Medicare enrollment 2
Other NPIs with the same Medicare PAC ID 6
Practitioners 2
-
Maureen Ann Kerins, RPH
-
Donna Marie Pawson, R.PH.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110921000296 | NJ | Part B Supplier - Mass Immunization (Roster Biller Only) | 9436278413 |
2 other NPIs on this enrollment Practice locations: Spotswood, NJ; Montague, NJ; Clark, NJ |
National Provider Directory
Locations
10A State Route 23
Montague, NJ 07827
Phone (973) 293-3273
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | RS006174 | NJ | |
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
10A RT. 23, Tri State Mall
Montague, NJ 07827
Mailing address
PO Box 29010
New York, NY 10087-9010
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3144514 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 7355408 | Medicaid | NJ |
Other names
- SHOPRITE PHARMACY OF MONTAGUE
Other providers in Montague, NJ
- Rha Health Services NJ LLC
- Nilda Margarita Rivera
- Shekera Robinson
- Sarah E Rome
- Innocent Urayai Rwakonda
- Sussex County Pediatric Associates
- Yiou Wang
- Eric Williams
- Willowglen Academy - New Jersey. Inc.
- Willowglen Academy-New Jersey, Inc.
All providers in Montague, NJ · Community/Retail Pharmacy in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.