Healthcare Provider Details

I. General information

NPI: 1669587440
Provider Name (Legal Business Name): SAKER SHOPRITES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 08/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2909 WASHINGTON RD
PARLIN NJ
08859-1513
US

IV. Provider business mailing address

922 HIGHWAY 33 BUILDING 6
FREEHOLD NJ
07728-8439
US

V. Phone/Fax

Practice location:
  • Phone: 732-525-0834
  • Fax: 732-525-1279
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberRS004308
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: 732-521-8439