Organization
PATHMARK STORES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEN LA PINTA RPH (SUPERVISOR)
(631) 586-4317
Entity
Organization
Contact information
Practice address
16417 GRAND CENTRAL PKWY, JAMAICA, NY 11432-1810
(718) 591-0978
Mailing address
16417 GRAND CENTRAL PKWY, JAMAICA, NY 11432-1810
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
45701
NY
3336C0003X
Community/Retail Pharmacy
Primary
45701
NY
Other
Enumeration date
03/06/2008
Last updated
03/06/2008
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