Healthcare Provider Details

I. General information

NPI: 1720193501
Provider Name (Legal Business Name): SAKER SHOPRITE'S INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 08/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 W UNION AVE
BOUND BROOK NJ
08805-1165
US

IV. Provider business mailing address

922 HIGHWAY 33 BUILDING 6
FREEHOLD NJ
07728-8439
US

V. Phone/Fax

Practice location:
  • Phone: 732-302-9070
  • Fax: 732-469-5159
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberRS005637
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MELISSA FIGUEROA RIVERA
Title or Position: THIRD PARTY ADMINISTRATOR
Credential:
Phone: 732-521-8448