# THE GREAT ATLANTIC AND PACIFIC TEA COMPANY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SUPER FRESH PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588689137
- **Authorized official:** SUSAN KIJOWSKI (PHARMACY SPECIALIST)
- **Authorized official phone:** (201) 571-8326

## Contact information

- **Practice address:** 780 CAMBRIDGE PLZ, CAMBRIDGE, MD 21613-2531
- **Practice address phone:** (410) 228-7608
- **Practice address fax:** (410) 228-7329
- **Mailing address:** 780 CAMBRIDGE PLZ, CAMBRIDGE, MD 21613-2531

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | P02504 | MD | — |
| 333600000X | Pharmacy | P02504 | MD | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 07/13/2006
- **Last updated:** 11/23/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2124345 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |