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4977 LLC NPI 1538274311


NPI Information

NPI: 1538274311
Provider Name: 4977, LLC

Doing Business As: SHOPRITE PHARMACY UPPER DEERFIELD

Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
1000 N PEARL ST
BRIDGETON, NJ
ZIP 08302
Phone: (856) 453-5993
Get Directions

4977, LLC is a pharmacy in Bridgeton, NJ. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. 4977, LLC NPI is 1538274311. The provider is registered as an organization entity type.
The provider Is Doing Business As Shoprite Pharmacy Upper Deerfield.

The provider's business location address is:

1000 N PEARL ST
BRIDGETON, NJ
ZIP 08302-215
Phone: (856) 453-5993
Fax: (856) 453-8631

The provider's authorized official is Melissa Figueroa Rivera .
The authorized official title is Third Party Administrator and has the following contact phone number (732) 521-8439.

The enumeration date for this NPI number is 8/20/2006 and was last updated on 8/10/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0003XPharmacyCommunity/Retail PharmacyNo
2333600000XPharmacyRS005859NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
18611602MEDICAIDNEW JERSEY
23142217OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
36644640001MEDICARE NSC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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