Healthcare Provider Details
I. General information
NPI: 1770698540
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: 12/29/2021
Certification Date: 12/29/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
860 FISCHER BLVD
TOMS RIVER NJ
08753-3824
US
IV. Provider business mailing address
10 CENTERVILLE RD
HOLMDEL NJ
07733-1103
US
V. Phone/Fax
- Phone: 732-270-0900
- Fax: 732-506-9347
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | RS002246 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAUL
E
FELLER
Title or Position: CHIEF PRIVACY AND SECURITY OFFICER
Credential:
Phone: 732-294-2278