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Organization

PATHMARK STORES INC

Active
Parent organization
THE GREAT ATLANTIC & PACIFIC TEA CO
Other names
PATHMARK PHARMACY
Organization subpart
Yes

Provider details

NPI number
Legal business name
THE GREAT ATLANTIC & PACIFIC TEA CO
Authorized official
SUSAN D KIJOWSKI (PHARMACY SPECIALIST)
(201) 571-8326
Entity
Organization

Contact information

Practice address
979 CHURCH RD, CHERRY HILL, NJ 08002-1301
(856) 482-5120
(856) 482-6004
Mailing address
2 PARAGON DR, MONTVALE, NJ 07645-1718
(291) 573-9700
(201) 571-8335

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
RS2800325300
NJ
333600000X
Pharmacy
RS003322
NJ
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3124675
OTHER ID NUMBER-COMMERCIAL NUMBER
05
4342801
NJ
Enumeration date
09/22/2006
Last updated
03/11/2009
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