Organization Active NPI

Shree-Shakti Inc

  • Pharmacy
  • Newark, NJ
National Provider Identifier
1912908773
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
4332504 Issued in NJ
Legal business name
SHREE-SHAKTI INC
Practice address
570 Bloomfield Ave
Newark, NJ 07107-1346
Phone
(973) 482-6753
Fax
(973) 482-0356
NPI assigned
Aug 2, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Authorized official

Name
Dr. Purnima Shailesh Shah, PHD, RPH
Title
Owner
Phone
(973) 482-6753

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 3019705 NJ
Pharmacy 333600000X 4332504 NJ Primary
Prosthetic/Orthotic Supplier 335E00000X 0035360 NJ

Addresses

Primary practice location

570 Bloomfield Ave
Newark, NJ 07107-1346

Mailing address

570 Bloomfield Ave
Newark, NJ 07107-1346
Phone (973) 482-6753

Other identifiers 4

IdentifierTypeStateIssuer
0035360MedicaidNJ
3019705MedicaidNJ
3103239OtherNJNAT ASSOC BOARD PHARMACY
4332504MedicaidNJ

Other names 1

  • DeRosa Pharmacy And Home HealthCare Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930089542 NJ DME Supplier - PharmacyDME Supplier - Medical Supply Company With Orthotic-ProstheticDME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Registered PharmacistDME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 3577681089 Practice locations: Newark, NJ
O20111128000044 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 3577681089 Practice locations: Newark, NJ

National Provider Directory

National Provider Directory
Tax ID family
Derosa Pharmacy3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751328000000",
    "number": "1912908773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 BLOOMFIELD AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071071346",
            "telephone_number": "973-482-6753",
            "fax_number": "973-482-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 BLOOMFIELD AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071071346",
            "telephone_number": "973-482-6753",
            "fax_number": "973-482-0356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHREE-SHAKTI INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "PURNIMA",
        "authorized_official_middle_name": "SHAILESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-482-6753",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NJ",
            "license": "3019705",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "4332504",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NJ",
            "license": "0035360",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0035360",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3019705",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NAT ASSOC BOARD PHARMACY",
            "identifier": "3103239",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4332504",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeRosa Pharmacy And Home HealthCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; 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.