Union Lake Supermarket LLC
NPI #1154521664 in Millville, New Jersey
Provider Information
- NPI Number
- 1154521664
- Entity Type
- Organization
- Organization Name
- Union Lake Supermarket LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Jul 23, 2007
- Last Updated
- Dec 1, 2011
Practice Location
- Address
- 2130 N 2ND ST
- City
- Millville
- State
- New Jersey
- ZIP Code
- 08332-1304
- Phone
- (856) 327-9950
Authorized Official
- Name
- MELISSA FIGUEROA-RIVERA
- Title
- THIRD PARTY ADMINISTRATOR
- Phone
- (732) 521-8439
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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