Organization
THE GREAT ATLANTIC AND PACIFIC TEA COMPANY INC
Active
Other names
A AND P PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN KIJOWSKI (PHARMACY SPECIALIST)
(201) 571-8326
Entity
Organization
Contact information
Practice address
789 SAINT GEORGE AVE, WOODBRIDGE, NJ 07095-3157
(732) 855-9412
(732) 855-9421
Mailing address
789 SAINT GEORGE AVE, WOODBRIDGE, NJ 07095-3157
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
05890
NJ
333600000X
Pharmacy
Primary
05890
NJ
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3142609
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
8399603
—
NJ
01
—
8399611
MEDICAID DME
NJ
Enumeration date
07/13/2006
Last updated
11/22/2007
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