Provider Demographics
NPI:1720193501
Name:SAKER SHOPRITE'S INC
Entity Type:Organization
Organization Name:SAKER SHOPRITE'S INC
Other - Org Name:SAKER SHOPRITES INC.
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:732-521-8448
Mailing Address - Street 1:922 HIGHWAY 33
Mailing Address - Street 2:BUILDING 6
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-8439
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:611 W UNION AVE
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-1165
Practice Address - Country:US
Practice Address - Phone:732-302-9070
Practice Address - Fax:732-469-5159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRS005637333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3140201OtherOTHER ID NUMBER-COMMERCIAL NUMBER
NJ7749813OtherMEDICAID DME
NJ7749805Medicaid
NJ7749805Medicaid