Provider Demographics
NPI:1942317136
Name:KLEINS OF ABERDEEN INC
Entity Type:Organization
Organization Name:KLEINS OF ABERDEEN INC
Other - Org Name:KLEIN'S SHOPRITE PHARMACY #548
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 1:949 BEARDS HILL RD
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001-1734
Mailing Address - Country:US
Mailing Address - Phone:410-272-3101
Mailing Address - Fax:410-272-6168
Practice Address - Street 1:949 BEARDS HILL RD
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-1734
Practice Address - Country:US
Practice Address - Phone:410-272-3101
Practice Address - Fax:410-272-6168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP015413336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD399932700Medicaid
0720200001Medicare NSC