NPIMap

Organization Active NPI

Village Super Market of NJ LP

Doing business as ShopRite Pharmacy of Vineland

  • Pharmacy
  • Vineland, NJ
National Provider Identifier
1851406631
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
RS005752 Issued in NJ
Legal business name
VILLAGE SUPER MARKET OF NJ LP
Doing business as
ShopRite Pharmacy of Vineland
Practice address
3600 E Landis Ave
Vineland, NJ 08361-3001
Phone
(856) 691-7722
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2011

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) 521-8448

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X RS005752 NJ Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

3600 E Landis Ave
Vineland, NJ 08361-3001

Mailing address

3600 E Landis Ave
Vineland, NJ 08361-3001

Other identifiers 2

IdentifierTypeStateIssuer
4377702MedicaidNJ
3128255OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • ShopRite Pharmacy of Vineland Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930009809 NJ DME Supplier - Pharmacy 3779604970 Practice locations: Vineland, NJ
O20111111000319 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 3779604970 22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Washington, NJ; West Orange, NJ; Vineland, NJ; Union, NJ; Stirling, NJ; Somerset, NJ; Somers Point, NJ; Rio Grande, NJ…

Other NPIs with the same Medicare PAC ID 18

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 18

Other NPIs on the same Medicare enrollment 22

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 22

National Provider Directory

National Provider Directory

Locations

3600 E Landis Ave
Vineland, NJ 08361
Phone (856) 691-7722

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318550400000",
    "number": "1851406631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 E LANDIS AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083613001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 E LANDIS AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083613001",
            "telephone_number": "856-691-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE SUPER MARKET OF NJ LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2011-10-14",
        "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": "732-521-8448"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "RS005752",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4377702",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3128255",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ShopRite Pharmacy of Vineland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vineland, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; 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.