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
13 NORTH AVE, PLEASANT VALLEY, NY 12569
(845) 635-1078
(845) 635-1096
Mailing address
PO BOX 1387, PLEASANT VALLEY, NY 12569-1387
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
025532
NY
333600000X
Pharmacy
Primary
025532
NY
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0235860442
MEDICAID DME
NY
05
—
02358607
—
NY
01
—
3328552
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
12/11/2006
Last updated
11/09/2007
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