Shoprite of Liberty Heights, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SHOPRITE OF LIBERTY HEIGHTS, LLC

Practice address

4601 Liberty Heights Ave
Baltimore, MD 21207-7553

Phone

(410) 666-1700

NPI assigned

Apr 16, 2014

Organization subpart

No

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

Addresses

Other names 1

• Shoprite Pharmacy of Howard Park Doing business as

Medicare fee-for-service enrollment

Enrolled in MD2 enrollments

Enrollment records 2

Tax ID family

Shoprite of Liberty Heights LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Shoprite of Liberty Heights, LLC

  • Clinic Pharmacy
  • Baltimore, MD
  • NPI 1306476106
  NPD tax ID

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457913600000",
    "number": "1942620091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 ROCK SPRING RD",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210502617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 LIBERTY HEIGHTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212077553",
            "telephone_number": "410-666-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOPRITE OF LIBERTY HEIGHTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-16",
        "last_updated": "2016-03-14",
        "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": "732-521-8439"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoprite Pharmacy of Howard Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kathryne Shomali
• Mansur E. Shomali, M.D.
• Brianna Nicole Shontz, OTR/L
• Daniella Shoob
• Shoprite of Liberty Heights, LLC
• Nava Shor
• Catherine Shorb
• Eliora Shore
• Kristin Shoresman
• Mary Elizabeth Shorey, MD

• Community/Retail Pharmacy in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Community/Retail Pharmacy in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; 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.