MEDICARE: SHOPRITE OF GLEN BURNIE LLC

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	3336C0003X	Community/Retail Pharmacy	P05386	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2135437	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1972817492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHOPRITE OF GLEN BURNIE LLC

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

Provider Business Practice Location Address
First Line	:	6716 RITCHIE HWY
Second Line	:
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-2319
Country	:	US
Telephone Number	:	443-572-0604
Fax Number	:	443-572-0607

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

Provider Enumeration Date	:	07/27/2010
Last Update Date	:	08/17/2012

Similar Medicare Providers

1134136211 — WALGREEN CO
Practice Location Address:

6700 RITCHIE HWY
GLEN BURNIE, MD
21061-2319

Practice Phone: 443-848-0245
Practice Fax:

1609908839 — UNITED THERAPY ASSOCIATES, P.A.
Practice Location Address:

6714 RITCHIE HWY , SUITE I
GLEN BURNIE, MD
21061-2319

Practice Phone: 410-787-2229
Practice Fax: 410-787-0141

1932231164 — DR. LAWRENCE STEVEN SAEZ DC
Practice Location Address:

6714 RITCHIE HWY , SUITE I
GLEN BURNIE, MD
21061-2319

Practice Phone: 410-787-2229
Practice Fax: 410-787-0141

1912139502 — MRS. SUZANNE M TAYLOR P.T.
Practice Location Address:

6714 RITCHIE HWY , SUITE I
GLEN BURNIE, MD
21061-2319

Practice Phone: 410-787-2229
Practice Fax: 410-787-0141

1164716064 — DAVID B.WOEHLKE, O.D., P.A.
Practice Location Address:

6718A RITCHIE HWY
GLEN BURNIE, MD
21061-2319

Practice Phone: 410-768-6101
Practice Fax:

1649551946 — TIFFANY DICHIARA RPH
Practice Location Address:

6700 RITCHIE HWY
GLEN BURNIE, MD
21061-2319

Practice Phone: 443-848-0245
Practice Fax: 443-848-0248

Directions to “SHOPRITE OF GLEN BURNIE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.