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Organization
PATHMARK STORES INC
Active
Organization
PATHMARK STORES INC
Active
Parent organization
THE GREAT ATLANTIC AND PACIFIC TEA COMPANY, INC.
Other names
PATHMARK PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE GREAT ATLANTIC AND PACIFIC TEA COMPANY, INC.
Authorized official
SUSAN D KIJOWSKI (REG COMPLIANCE SPECIALIST)
(201) 571-8326
Entity
Organization
Contact information
Practice address
130 WHEATLEY PLZ, GREENVALE, NY 11548-1316
(516) 484-1414
(516) 484-1371
Mailing address
2 PARAGON DR, MONTVALE, NJ 07645-1718
(201) 573-9700
(201) 571-8335
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
013582
NY
333600000X
Pharmacy
Primary
013582
NY
3336C0003X
Community/Retail Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00383335
—
NY
01
—
3313878
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/20/2006
Last updated
04/11/2011
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