Organization
PATHMARK STORES INC
Active
Parent organization
THE GREAT ATLANTIC & PACIFIC TEA CO., INC.
Other names
PATHMARK PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE GREAT ATLANTIC & PACIFIC TEA CO., INC.
Authorized official
SUSAN D KIJOWSKI (REG COMPLIANCE SPEC)
(201) 571-8326
Entity
Organization
Contact information
Practice address
195 ROCKLAND CTR, NANUET, NY 10954-2956
(845) 623-6220
(845) 627-1947
Mailing address
2 PARAGON DR, MONTVALE, NJ 07645-1718
(201) 573-9700
(201) 571-8335
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
015990
NY
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00513075
—
NY
01
—
3364572
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/26/2006
Last updated
11/08/2011
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