Provider Demographics
NPI:1609981489
Name:SAKER SHOPRITES INC.
Entity Type:Organization
Organization Name:SAKER SHOPRITES INC.
Other - Org Name:SHOPRITE PHARMACY #521
Other - Org Type:Other Name
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 1:130 MARKETPLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-2103
Mailing Address - Country:US
Mailing Address - Phone:609-581-5827
Mailing Address - Fax:609-581-7783
Practice Address - Street 1:130 MARKETPLACE BLVD
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08691-2103
Practice Address - Country:US
Practice Address - Phone:609-581-5827
Practice Address - Fax:609-581-7783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRS006304333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3145643OtherOTHER ID NUMBER-COMMERCIAL NUMBER
NJ0012203Medicaid
NJ0012211OtherMEDICAID DME
NJ0012211OtherMEDICAID DME