Organization Active NPI

Shoprite Supermarkets, Inc

Doing business as Shoprite Pharmacy

  • Community/Retail Pharmacy
  • New Rochelle, NY
National Provider Identifier
1891024790
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SHOPRITE SUPERMARKETS, INC
Doing business as
Shoprite Pharmacy
Practice address
8 Joyce Rd
New Rochelle, NY 10801-4320
Phone
(914) 740-9767
Fax
(914) 740-9769
NPI assigned
Dec 24, 2009
Last updated
Jun 24, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

8 Joyce Rd
New Rochelle, NY 10801-4320

Mailing address

PO Box 29010
New York, NY 10087-9010
Phone (914) 740-9767

Other identifiers 1

IdentifierTypeStateIssuer
03196930MedicaidNY

Other names 1

  • Shoprite Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110110000400 NY Part B Supplier - Mass Immunization (Roster Biller Only) 9436278413 15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Carmel, NY; Hudson, NY; Monticello, NY

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1261612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277337600000",
    "number": "1891024790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29010",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100879010",
            "telephone_number": "914-740-9767",
            "fax_number": "914-740-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 JOYCE RD",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108014320",
            "telephone_number": "914-740-9767",
            "fax_number": "914-740-9769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPRITE SUPERMARKETS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-24",
        "last_updated": "2010-06-24",
        "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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03196930",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoprite Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Rochelle, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; 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.