Organization
FOOD BASICS, INC
Active
Parent organization
GREAT ATLANTIC & PACIFIC TEA CO., INC.
Other names
DRUG BASICS PHARMACY # 036
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREAT ATLANTIC & PACIFIC TEA CO., INC.
Authorized official
SUSAN D KIJOWSKI (MANAGER, REGULATORY COMPLIANCE)
(201) 571-8326
Entity
Organization
Contact information
Practice address
498 E 30TH ST, PATERSON, NJ 07504-2133
(973) 278-4151
Mailing address
PO BOX 416369, BOSTON, MA 02241-6369
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
28RS00694700
NJ
333600000X
Pharmacy
Primary
28RS00694700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28RS00694700
LICENSE
NJ
01
—
D09527400
NJ CDS
NJ
Enumeration date
07/23/2009
Last updated
10/11/2011
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