Organization
GREAT ATLANTIC & PACIFIC TEA COMPANY INC
Active
Other names
A & P PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN KIJOWSKI (MANAGER, REGULATORY COMPLIANCE)
(201) 571-8326
Entity
Organization
Contact information
Practice address
455 STATE RT 23, SUSSEX, NJ 07461-2212
(973) 875-5701
(973) 875-2731
Mailing address
PO BOX 416369, BOSTON, MA 02241-6369
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
06082
NJ
333600000X
Pharmacy
Primary
06082
NJ
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3144095
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
8804001
—
NJ
01
—
8804010
MEDICAID DME
NJ
Enumeration date
07/13/2006
Last updated
10/11/2011
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