MEDICARE: RICHARD J. MCMENAMIN INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PP413919L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2086021	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861507642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD J. MCMENAMIN INC.

Provider Business Mailing Address
First Line	:	PO BOX 15169
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07192-5169
Country	:	US
Telephone Number	:	215-673-1210
Fax Number	:

Provider Business Practice Location Address
First Line	:	11000 ROOSEVELT BLVD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19116-3961
Country	:	US
Telephone Number	:	215-673-1210
Fax Number	:	215-673-4209

Authorized Official
Title or Position	:	THIRD PARTY ADMINISTRATOR
Name	:	MELISSA FIGUEROA RIVERA
Credential	:
Telephone Number	:	732-521-8439

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	09/19/2025

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