NPIMap

Organization Active NPI

Village Super Market of NJ LP

Doing business as ShopRite Pharmacy of Absecon

  • Community/Retail Pharmacy
  • Absecon, NJ
National Provider Identifier
1962547596
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
RS003831 Issued in NJ
Legal business name
VILLAGE SUPER MARKET OF NJ LP
Doing business as
ShopRite Pharmacy of Absecon
Practice address
616 White Horse Pike
Absecon, NJ 08201-2302
Phone
(609) 646-0444
Fax
(609) 383-3578
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2011

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X RS003831 NJ Primary

Addresses

Primary practice location

616 White Horse Pike
Absecon, NJ 08201-2302

Mailing address

616 White Horse Pike
Absecon, NJ 08201-2302
Phone (609) 646-0444

Other identifiers 2

IdentifierTypeStateIssuer
3124663OtherNJNCPDP
4375009MedicaidNJ

Other names 1

  • ShopRite Pharmacy of Absecon Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930004753 NJ DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered PharmacistDME Supplier - Grocery Store 3779604970 Practice locations: Absecon, 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

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

Locations

616 White Horse Pike
Absecon, NJ 08201
Phone (609) 646-0444

Practitioners & affiliated clinicians

Practitioners 2

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": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318550400000",
    "number": "1962547596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 WHITE HORSE PIKE",
            "city": "ABSECON",
            "state": "NJ",
            "postal_code": "082012302",
            "telephone_number": "609-646-0444",
            "fax_number": "609-383-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 WHITE HORSE PIKE",
            "city": "ABSECON",
            "state": "NJ",
            "postal_code": "082012302",
            "telephone_number": "609-646-0444",
            "fax_number": "609-383-3578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE SUPER MARKET OF NJ LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2011-10-14",
        "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": "732-521-8448"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "RS003831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3124663",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4375009",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ShopRite Pharmacy of Absecon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Absecon, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; 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.