Waverly Markets of Vernon LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

WAVERLY MARKETS OF VERNON LLC

Practice address

35 Talcottville Rd
Vernon, CT 06066-5261

Phone

(860) 872-8961

NPI assigned

Apr 11, 2019

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 2

Addresses

Other names 1

• Shoprite Pharmacy of Vernon Doing business as

Medicare fee-for-service enrollment

Enrolled in CT2 enrollments

Enrollment records 2

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

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554940800000",
    "number": "1760945125",
    "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": "35 TALCOTTVILLE RD",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060665261",
            "telephone_number": "860-872-8961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVERLY MARKETS OF VERNON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-11",
        "last_updated": "2019-04-11",
        "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 Pharmacy of Vernon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicolle Wargo-Boswell
• Susan Flaherty Washburn, MD
• David A Wasserstein, MD
• Danielle M Watters, MS, ACSM-CEP
• Jonathan P. Watts, L.P.C
• Lindsay Wayman, APRN
• Lina Michelle Weber, PA
• Wednesday Morning LLC
• Howard Kenneth Weiner, M.D.
• Christina Rose Welch, M.A., CCC-SLP

• Community/Retail Pharmacy in Vernon, CT
• Providers in Vernon, 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 Apr 11, 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.