Shoprite of Waterbury, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PCY1125 Issued in CT

Legal business name

SHOPRITE OF WATERBURY, LLC

Practice address

943 Wolcott St
Waterbury, CT 06705-1301

Phone

(203) 753-1718

Fax

(203) 757-2095

NPI assigned

Feb 8, 2007

Last updated

Jan 5, 2012By the provider in NPPES

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 4

Addresses

Other identifiers 2

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325721600000",
    "number": "1699815589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 WOLCOTT ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067051301",
            "telephone_number": "203-753-1718",
            "fax_number": "203-757-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 WOLCOTT ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067051301",
            "telephone_number": "203-753-1718",
            "fax_number": "203-757-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPRITE OF WATERBURY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2012-01-05",
        "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": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "PCY1125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0709204",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004032199",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shohan Shetty, MD
• Bethel Girma Shiferaw, M.D.
• Alicia Shiland
• Molly Margaret Shipman, D.O.
• Zelda Shleifer, AU.D., CCC-A
• Andrea Shulick, PA-C
• Athela E Sibilia, LCSW
• Marissa Siemiatkoski
• Sierra Counseling LLC
• Jonathan E. Silbert, M.D.

• Community/Retail Pharmacy in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Community/Retail Pharmacy in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; 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.