Healthcare Provider Details

I. General information

NPI: 1689789455
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: 06/18/2021
Certification Date: 06/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1732 HIGHWAY 35
WALL TOWNSHIP NJ
07719-3440
US

IV. Provider business mailing address

10 CENTERVILLE RD
HOLMDEL NJ
07733-1103
US

V. Phone/Fax

Practice location:
  • Phone: 732-681-0550
  • Fax: 732-681-5463
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberRS002169
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