NPIMap

Organization Active NPI

Village Super Market of NJ LP

  • Pharmacy
  • East Orange, NJ
National Provider Identifier
1871608646
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
RS003877 Issued in NJ
Legal business name
VILLAGE SUPER MARKET OF NJ LP
Practice address
533 Main St
East Orange, NJ 07018-2215
Phone
(973) 674-8822
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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 RS003877 NJ Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

533 Main St
East Orange, NJ 07018-2215

Mailing address

733 Mountain Ave
Springfield, NJ 07081-3223

Other identifiers 2

IdentifierTypeStateIssuer
3103277OtherOTHER ID NUMBER-COMMERCIAL NUMBER
4380304MedicaidNJ

Other names 1

  • Shoprite Pharmacy of East Orange Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930035097 NJ DME Supplier - PharmacyDME Supplier - Grocery Store 3779604970 Practice locations: East Orange, 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

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 Pharmacy533 Main St, East Orange, NJ 07018-2215(973) 674-8822 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Aug 11, 2011

National Provider Directory

National Provider Directory
Tax ID family
Shakoor Supermarkets Inc17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Practitioners & affiliated clinicians

Practitioners 2

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": "1422576000000",
    "number": "1871608646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 MOUNTAIN AVE",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070813223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 MAIN ST",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070182215",
            "telephone_number": "973-674-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE SUPER MARKET OF NJ LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2015-01-30",
        "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": "RS003877",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3103277",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4380304",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoprite Pharmacy of East Orange",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; 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.