Organization
PATHMARK STORES INC
Active
Parent organization
THE GREAT ATLANTIC AND PACIFIC TEA CO INC
Other names
PATHMARK PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE GREAT ATLANTIC AND PACIFIC TEA CO INC
Authorized official
SUSAN D KIJOWSKI (PHARMACY SPECIALIST)
(201) 571-8326
Entity
Organization
Contact information
Practice address
422 GRAND ST, JERSEY CITY, NJ 07302-4240
(201) 432-5513
(201) 432-2261
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
28RS00362900
NJ
333600000X
Pharmacy
Primary
RS003629
NJ
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3126770
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
4360702
—
NJ
Enumeration date
09/20/2006
Last updated
10/05/2010
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