Provider Demographics
NPI:1023218526
Name:EEE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:EEE ASSOCIATES, LLC
Other - Org Name:SHOPRITE PHARMACY OF ARK ROAD
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KARL
Authorized Official - Middle Name:W
Authorized Official - Last Name:EICKHOFF
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:732-521-8439
Mailing Address - Street 1:1310 FAIRVIEW BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075
Mailing Address - Country:US
Mailing Address - Phone:856-824-0394
Mailing Address - Fax:856-824-0479
Practice Address - Street 1:127 ARK RD
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-6302
Practice Address - Country:US
Practice Address - Phone:856-359-2181
Practice Address - Fax:856-359-2190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
6033890001Medicare NSC