Organization
THE GREAT ATLANTIC AND PACIFIC TEA COMPANY INC
Active
Other names
SUPER FRESH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN KIJOWSKI (PHARMACY SPECIALIST)
(201) 571-8326
Entity
Organization
Contact information
Practice address
2401 CLEANLEIGH DR, BALTIMORE, MD 21234-6808
(410) 663-9602
(410) 663-9608
Mailing address
PO BOX 23069, NEWARK, NJ 07189-0001
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
P01966
MD
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2120892
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/13/2006
Last updated
09/11/2025
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