Provider Demographics
NPI:1114032992
Name:SAKER SHOPRITES INC.
Entity type:Organization
Organization Name:SAKER SHOPRITES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:THIRD PARTY ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGUEROA RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-521-8439
Mailing Address - Street 1:400 RENAISSANCE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-5100
Mailing Address - Country:US
Mailing Address - Phone:732-940-9451
Mailing Address - Fax:732-940-7692
Practice Address - Street 1:400 RENAISSANCE BLVD
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-5100
Practice Address - Country:US
Practice Address - Phone:732-940-9451
Practice Address - Fax:732-940-7692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRS004241333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4403304Medicaid
NJ4403312OtherMEDICAID DME
3130426OtherOTHER ID NUMBER-COMMERCIAL NUMBER
NJ5914030025Medicare NSC