Healthcare Provider Details

I. General information

NPI: 1871415596
Provider Name (Legal Business Name): INSERRA SUPERMARKETS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

481 RIVER RD
EDGEWATER NJ
07020-1145
US

IV. Provider business mailing address

481 RIVER RD
EDGEWATER NJ
07020-1145
US

V. Phone/Fax

Practice location:
  • Phone: 973-728-4754
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RICHARD B CHAMBERLAIN
Title or Position: VP FINANCE
Credential:
Phone: 201-529-5900