Organization Active NPI

Cromwell Markets LLC

Doing business as Shoprite of Cromwell

  • Community/Retail Pharmacy
  • Cromwell, CT
National Provider Identifier
1750846689
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
CROMWELL MARKETS LLC
Doing business as
Shoprite of Cromwell
Practice address
45 Shunpike Rd
Cromwell, CT 06416-2447
Phone
(860) 613-0741
Fax
(860) 613-9912
NPI assigned
Feb 5, 2019
Last updated
May 1, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

45 Shunpike Rd
Cromwell, CT 06416-2447

Mailing address

PO Box 15169
Newark, NJ 07192-5169

Other names 1

  • Shoprite of Cromwell Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190716000780 CT DME Supplier - PharmacyDME Supplier - Grocery Store 7012242837 Practice locations: Cromwell, CT
O20190717003692 CT Part B Supplier - Mass Immunization (Roster Biller Only) 7012242837 Practice locations: Cromwell, CT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Shoprite of Cromwell45 Shunpike Rd, Cromwell, CT 06416-2447(860) 613-0741 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Orthoses: Off-The-Shelf|Nebulizer Equipment and/or Supplies Accepts assignmentParticipating since May 18, 2019

National Provider Directory

National Provider Directory

Locations

45 Shunpike Rd
Cromwell, CT 06416
Phone (860) 613-0741

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556668800000",
    "number": "1750846689",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 SHUNPIKE RD",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162447",
            "telephone_number": "860-613-0741",
            "fax_number": "860-613-9912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROMWELL MARKETS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-05-01",
        "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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoprite of Cromwell",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shoprite of Cromwell",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cromwell, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.