PATHMARK STORES INC (NPI# 1245337005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245337005 |
| Entity Type | Organization |
| Organization Name | PATHMARK STORES INC |
| Other Organization Name | PATHMARK PHARMACY |
| Practice Address |
4055 Merrick Rd Seaford NY 11783-2830 |
| Mailing Address |
2 Paragon Dr Montvale NJ 07645-1718 |
| Practice Telephone | 5168266767 |
| Practice Fax Number | 5168264477 |
| Mailing Telephone | 2015739700 |
| Mailing Fax Number | 2015718335 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2010-10-08 |
| Authorized Official Name | SUSAN D KIJOWSKI (REGULATORY COMPLIANCE SPECIALIST) |
| Authorized Official Telephone | 2015718326 |
| Is Organization Subpart | Y |
| Parent Organization Name | THE GREAT ATLANTIC & PACIFIC TEA CO., INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 012824 | NY | Suppliers |
| Y | 333600000X | Pharmacy | 012824 | NY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 3313931 | 01 | |
| NY | 00383371 | 05 |
| Other Name | Type Code |
|---|---|
| PATHMARK PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770684144 | Pathmark Stores Inc | Pharmacy | 195 Rockland Ctr, Nanuet, NY 10954-2956 | 2006-09-26 |
| 1134220502 | Pathmark Stores Inc | Durable Medical Equipment & Medical Supplies | Kmart Plaza Us Rt 10, Randolph, NJ 07869 | 2006-09-26 |
| 1043311418 | Pathmark Stores Inc | Pharmacy | Route 440 and Kellogg St, Jersey City, NJ 07305 | 2006-09-26 |
| 1548360589 | Pathmark Stores Inc | Pharmacy | 405 Rt 17, Hackensack, NJ 07601 | 2006-09-22 |
| 1285733253 | Pathmark Stores Inc | Pharmacy | 2110 Rt 130, Beverly, NJ 08010 | 2006-09-22 |
| 1407956436 | Pathmark Stores Inc | Durable Medical Equipment & Medical Supplies | 979 Church Rd, Cherry Hill, NJ 08002-1301 | 2006-09-22 |
| 1679673602 | Pathmark Stores Inc | Durable Medical Equipment & Medical Supplies | 759 Rt 15 South, Lake Hopatcong, NJ 07849 | 2006-09-22 |
| 1558461590 | Pathmark Stores Inc | Durable Medical Equipment & Medical Supplies | 100 Greaves Lane, Staten Island, NY 10308-2171 | 2006-09-22 |
| 1588764518 | Pathmark Stores Inc | Pharmacy | 35 Lackawanna Plaza, Montclair, NJ 07042 | 2006-09-22 |
| 1851491898 | Pathmark Stores Inc | Pharmacy | 10 Triangle 17 Plaza, Ramsey, NJ 07446 | 2006-09-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Retail Food Store | PATHMARK STORES INC | 5145 NESCONSET HWY PORT JEFFERSON STA NY 11776 |
| Street Address |
4055 MERRICK RD |
| City | SEAFORD |
| State | NY |
| Zip Code | 11783-2830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689044810 | Stop and Shop Supermarket Co LLC | Durable Medical Equipment & Medical Supplies | 4055 Merrick Rd, Seaford, NY 11783-2830 | 2015-09-30 |
| 1922277623 | Brigitte S Zeitoun | Pharmacist | 4055 Merrick Rd, Seaford, NY 11783-2830 | 2008-02-27 |
| 1558530337 | Martha M Mille | Pharmacist | 4055 Merrick Rd, Seaford, NY 11783-2830 | 2008-02-26 |
| 1538337571 | James Francis Fitzgerald | Pharmacist | 4055 Merrick Rd, Seaford, NY 11783-2830 | 2008-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174165633 | Emily Rose Demino | Physician Assistant | 3833 Morton Lane, Seaford, NY 11783 | 2019-10-16 |
| 1396260857 | Melissa Cestro | Social Worker | 2565 Harvard Lane, Seaford, NY 11783 | 2017-08-07 |
| 1033535745 | Ronna Pine | Licensed Practical Nurse | 3894 Jane Court, Seaford, NY 11783 | 2014-03-06 |
| 1871831974 | Joanne Sheridan | Speech-Language Pathologist | 751 Seamans Neck Road, East Broadway School, Seaford, NY 11783 | 2013-01-24 |
| 1154685840 | Cindy Schiralli | Specialist | The Hagedorn Little Village School, 650 Hicksville Road, Seaford, NY 11783 | 2012-06-27 |
| 1124389085 | Rosemary Ross | Specialist | 750 Hicksville Road, Seaford, NY 11783 | 2012-06-06 |
| 1760755326 | Seymour Tobin | Family Medicine | 4008 New York Ave, Seaford, NY 11783 | 2012-02-13 |
| 1104198811 | Lisl I Kast | Dentist | 3579 Merrick Rd, Senford, NY 11783 | 2012-01-27 |
| 1609146869 | Lisa Louise Gagliano | Speech-Language Pathologist | 1839 Dogwood Lane, Seaford, NY 11783 | 2012-01-05 |
| 1073843728 | Laura Musillo | Registered Nurse | 4125 Bayberry Lane, Seaford, NY 11783 | 2009-12-31 |
| Find all providers in zip 11783 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
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|---|---|---|---|---|
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| 1962759316 | Civic Health Services 2 LLC | Pharmacy | 613 W Stein Hwy, Seaford, DE 19973-1203 | 2012-08-04 |
| 1013044858 | Seaford Chemists Quaile Pharmacy | Pharmacy | 1696 Washington Ave, Seaford, NY 11783-1903 | 2007-02-28 |
| 1073685855 | Sth Associates Inc | Pharmacy | 630 W Stein Hwy, Seaford, DE 19973-1204 | 2006-11-15 |
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| 1679182349 | Marvel Pharmacy Inc | Pharmacy | 9612 Liberty Ave, Ozone Park, NY 11417-1624 | 2020-07-28 |
| 1114545837 | Edgar Murcia | Pharmacy | 7702 Roosevelt Ave Ste C, Jackson Heights, NY 11372-6604 | 2020-07-09 |
| 1811513724 | Link Pharmacy | Pharmacy | 456 Avenue P, Brooklyn, NY 11223-2895 | 2020-06-17 |
| 1396361259 | Banani Road 11 LLC | Pharmacy | 181-04 Hillside Ave, Jamaica, NY 11432 | 2020-06-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.