Provider Demographics
NPI:1083729867
Name:SAKER SHOPRITES INC
Entity Type:Organization
Organization Name:SAKER SHOPRITES INC
Other - Org Name:SHOPRITE PHARMACY #616
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF PRIVACY AND SECURITY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:FELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-294-2278
Mailing Address - Street 1:10 CENTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1103
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:260 N COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-4473
Practice Address - Country:US
Practice Address - Phone:732-886-7006
Practice Address - Fax:732-886-5016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRS006094333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3144134OtherOTHER ID NUMBER-COMMERCIAL NUMBER
8772517OtherMEDICAID DME
NJ8772509Medicaid
8772517OtherMEDICAID DME