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
195 N BEDFORD RD, MOUNT KISCO, NY 10549-1140
(914) 241-2688
(914) 241-2619
Mailing address
195 N BEDFORD RD, MOUNT KISCO, NY 10549-1140
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
026930
NY
333600000X
Pharmacy
Primary
026930
NY
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02621603
—
NY
01
—
026216030442
MEDICAID DME
NY
01
—
3340558
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/13/2006
Last updated
11/09/2007
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