Provider Demographics
NPI:1073629499
Name:SAKER SHOPRITES INC
Entity Type:Organization
Organization Name:SAKER SHOPRITES INC
Other - Org Name:SHOPRITE PHARMACY #533
Other - Org Type:Doing Business As
Authorized Official - Title/Position:THIRD PARTY ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGUEROA RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-521-8439
Mailing Address - Street 1:2555 PENNINGTON RD
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-3216
Mailing Address - Country:US
Mailing Address - Phone:609-737-0606
Mailing Address - Fax:609-737-0430
Practice Address - Street 1:2555 PENNINGTON RD
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-3216
Practice Address - Country:US
Practice Address - Phone:609-737-0606
Practice Address - Fax:609-737-0430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRS006553000333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3193062OtherOTHER ID NUMBER-COMMERCIAL NUMBER
NJ0096539OtherMEDICAID DME
NJ8177406Medicaid
NJ5914030002Medicare NSC