Healthcare Provider Details

I. General information

NPI: 1013057314
Provider Name (Legal Business Name): RONETCO SUPERMARKETS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 US HIGHWAY #23
FRANKLIN NJ
07416
US

IV. Provider business mailing address

1070 US HIGHWAY 46 STE 17
LEDGEWOOD NJ
07852-9701
US

V. Phone/Fax

Practice location:
  • Phone: 973-827-1806
  • Fax: 973-827-0949
Mailing address:
  • Phone: 973-927-8300
  • Fax: 973-927-4953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberRS004898
License Number StateNJ

VIII. Authorized Official

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