# PATHMARK STORES INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THE GREAT ATLANTIC & PACIFIC TEA CO
- **Other names:** PATHMARK PHARMACY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1407956436
- **Legal business name:** THE GREAT ATLANTIC & PACIFIC TEA CO
- **Authorized official:** SUSAN D KIJOWSKI (PHARMACY SPECIALIST)
- **Authorized official phone:** (201) 571-8326

## Contact information

- **Practice address:** 979 CHURCH RD, CHERRY HILL, NJ 08002-1301
- **Practice address phone:** (856) 482-5120
- **Practice address fax:** (856) 482-6004
- **Mailing address:** 2 PARAGON DR, MONTVALE, NJ 07645-1718
- **Mailing address phone:** (291) 573-9700
- **Mailing address fax:** (201) 571-8335

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | RS2800325300 | NJ | — |
| 333600000X | Pharmacy | RS003322 | NJ | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 09/22/2006
- **Last updated:** 03/11/2009