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General NPI Number Information
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NPI Number | 1245672237
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Entity Type | Organization
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Legal Business Name | EAST HAVEN MARKETS LLC
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Dates
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Enumeration Date | 07/19/2013
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 745 FOXON RD
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City | EAST HAVEN
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State | CT
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Zip | 06513-1873
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Country | US
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Telephone | 475-202-5184
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Fax | 475-202-5187
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Provider Business Mailing Address
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Address Line | P.O. BOX 15169
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City | NEWARK
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State | NJ
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Zip | 07192
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Country | US
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Telephone | 475-202-5184
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Fax |
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Authorized Official
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Title or Position | THIRD PARTY ADMINISTRATOR
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Name | MELISSA FIGUEROA RIVERA
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Credential |
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Telephone | 732-521-8439
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PCY0002277
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License Number State | CT
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