PATHMARK STORES INC (NPI# 1285733253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285733253 |
| Entity Type | Organization |
| Organization Name | PATHMARK STORES INC |
| Other Organization Name | PATHMARK PHARMACY |
| Practice Address |
2110 Rt 130 Beverly NJ 08010 |
| Mailing Address |
2 Paragon Dr Montvale NJ 07645-1718 |
| Practice Telephone | 6098711550 |
| Practice Fax Number | 6098777719 |
| Mailing Telephone | 2015739700 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2008-09-29 |
| Authorized Official Name | SUSAN D KIJOWSKI (PHARMACY 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 | ||
| Y | 333600000X | Pharmacy | RS02202 | NJ | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 3102720 | 01 | |
| NJ | 4291409 | 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 |
| 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 |
| 1023118064 | Pathmark Stores Inc | Pharmacy | 2335 New Hyde Park Rd, New Hyde Park, NY 11042 | 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 |
2110 RT 130 |
| City | BEVERLY |
| State | NJ |
| Zip Code | 08010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316460488 | Ap Healing Hands Home Care, Corp. | In Home Supportive Care | 424 Cooper St Gr Fl Unit 3, Beverly, NJ 08010 | 2017-07-20 |
| 1528418209 | Dungarvin New Jersey, LLC-park | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 19 Park Ave, Beverly, NJ 08010 | 2016-06-14 |
| 1427214915 | Beverly Emergency Squad Inc | Ambulance | 703 Melbourne Ave, Beverly, NJ 08010 | 2008-08-04 |
| 1912101155 | Faith Christian Counseling Center Inc | Counselor | 215 Locust St, Beverly, NJ 08010 | 2007-06-12 |
| 1336158146 | George G Flamm | Family Medicine | 440 Cooper Street, Beverly, NJ 08010 | 2006-08-08 |
| 1285014365 | National Mentor Healthcare, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 216 Laurel St, Beverly, NJ 08010-1226 | 2015-06-04 |
| 1437156049 | Donald G Teicher | Dentist | 459 Warren St E, Edgewater Park, NJ 08010-1432 | 2005-06-29 |
| 1043437387 | Beverly City Board of Education | Local Education Agency (LEA) | 601 Bentley Ave, Beverly, NJ 08010-1523 | 2007-04-19 |
| 1669462636 | W. Albert Dow | Family Medicine | 455 Broad St, Beverly, NJ 08010-1545 | 2005-10-21 |
| 1720435548 | Kyle Riley | Counselor | 711 Delanco Rd, Edgewater Park, NJ 08010-1603 | 2016-05-23 |
| Find all providers in zip 08010 | ||||
| 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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| 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.