NPIMap

Organization Active NPI

Shoprite Pharmacy 145

Doing business as Shoprite Pharmacy

  • Community/Retail Pharmacy
  • Staten Island, NY
National Provider Identifier
1881709665
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SHOPRITE PHARMACY 145
Doing business as
Shoprite Pharmacy
Practice address
2424 Hylan Blvd
Staten Island, NY 10306-3117
Phone
(718) 979-0718
Fax
(718) 979-5462
NPI assigned
Aug 20, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mona Gadkari
Title
Third Party Administrator
Phone
(732) 521-8448

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 24150 NY
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

2424 Hylan Blvd
Staten Island, NY 10306-3117

Mailing address

355 Davidsons Mill Rd
Jamesburg, NJ 08831-3014

Other identifiers 2

IdentifierTypeStateIssuer
3301645OtherOTHER ID NUMBER-COMMERCIAL NUMBER
01912629MedicaidNY

Other names 1

  • SHOPRITE PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Shoprite Pharmacy8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

2424 Hylan Blvd
Staten Island, NY 10306
Phone (718) 979-0718

Practitioners & affiliated clinicians

Practitioners 4

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1881709665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 DAVIDSONS MILL RD",
            "city": "JAMESBURG",
            "state": "NJ",
            "postal_code": "088313014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063117",
            "telephone_number": "718-979-0718",
            "fax_number": "718-979-5462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPRITE PHARMACY 145",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "GADKARI",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "THIRD PARTY ADMINISTRATOR",
        "authorized_official_telephone_number": "732-521-8448"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "24150",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3301645",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01912629",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHOPRITE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.