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Organization
PATHMARK STORES, INC.
Active
Organization
PATHMARK STORES, INC.
Active
Parent organization
THE GREAT ATLANTIC & PACIFIC TEA COMPANY, INC.
Other names
Pathmark Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE GREAT ATLANTIC & PACIFIC TEA COMPANY, INC.
Authorized official
SUSAN D KIJOWSKI (REGULATORY COMPLIANCE SPECIALIST)
(201) 571-8326
Entity
Organization
Contact information
Practice address
237-239 CHERRY ST, NEW YORK, NY 10002-0000
(212) 227-3520
(212) 393-1275
Mailing address
2 PARAGON DRIVE, MONTVALE, NJ 07645-1718
(201) 571-8326
(201) 571-8335
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
017977
NY
333600000X
Pharmacy
Primary
017977
NY
3336C0003X
Community/Retail Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00804980
—
NY
01
—
3378141
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/20/2006
Last updated
11/15/2010
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