PATHMARK STORES INC (NPI# 1730286592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730286592 |
| Entity Type | Organization |
| Organization Name | PATHMARK STORES INC |
| Other Organization Name | PATHMARK PHARMACY |
| Practice Address |
130 White Horse Pike N Lawnside NJ 08045-1128 |
| Mailing Address |
2 Paragon Dr Montvale NJ 07645-1718 |
| Practice Telephone | 8565465111 |
| Practice Fax Number | 8566729346 |
| Mailing Telephone | 2015739700 |
| Mailing Fax Number | 2015718335 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-12-12 |
| 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 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | RS2800325300 | NJ | Suppliers |
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | RS002211 | NJ | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 3102910 | 01 | |
| NJ | 4287509 | 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 |
130 WHITE HORSE PIKE N |
| City | LAWNSIDE |
| State | NJ |
| Zip Code | 08045-1128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053650119 | Lawnside Shoprite LLC | Pharmacy | 130 White Horse Pike N, Lawnside, NJ 08045-1128 | 2013-02-11 |
| 1134387301 | Catherine Mary Crisfulla | Pharmacist | 130 White Horse Pike N, Lawnside, NJ 08045-1128 | 2008-05-23 |
| 1730358177 | Ann M. Mewherter | Pharmacist | 130 White Horse Pike N, Lawnside, NJ 08045-1128 | 2008-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508034455 | Gary A Dock Sr. | Counselor | 190 W Oak Ave Apt A, Lawnside, NJ 08045 | 2008-02-13 |
| 1861872939 | National Mentor Healthcare, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 354 Quaker Rd, Lawnside, NJ 08045-1015 | 2015-06-04 |
| 1629155544 | James L Hewitt | Psychiatry & Neurology | 442 Warwick Rd N, Lawnside, NJ 08045-1024 | 2006-11-01 |
| 1982846200 | Hewitt Psychiatric PC | Psychiatry & Neurology | 442 Warwick Rd N, Lawnside, NJ 08045-1024 | 2009-04-01 |
| 1306923222 | Joseph C Hewitt | Psychiatry & Neurology | 442 Warwick Rd N, Lawnside, NJ 08045-1024 | 2006-11-01 |
| 1487952693 | Nailah Akanke Green | Counselor | 220 Bryant Ave, Lawnside, NJ 08045-1108 | 2011-03-11 |
| 1336695485 | Madearia Lynette Lowery | Community Based Residential Treatment Facility, Mental Illness | 202 Hilliard T Moore Ave, Lawnside, NJ 08045-1122 | 2016-08-29 |
| 1487704698 | Cole Vision Corporation | Eyewear Supplier (Equipment, not the service) | 200 White Horse Pike N, Lawnside, NJ 08045-1155 | 2007-01-11 |
| 1003136631 | Jina Ahn | Pharmacist | 200 White Horse Pike N, Lawnside, NJ 08045-1155 | 2010-06-05 |
| 1275564312 | K Mart Corp | Pharmacy | 200 White Horse Pike N, Lawnside, NJ 08045-1155 | 2006-07-06 |
| Find all providers in zip 08045 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275564312 | K Mart Corp | Pharmacy | 200 White Horse Pike N, Lawnside, NJ 08045-1155 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801495544 | Medilink Rxcare Hammonton, LLC | Pharmacy | 44 S White Horse Pike, Hammonton, NJ 08037-1845 | 2020-10-23 |
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| 1043828577 | Siddhivinayak Inc. | Pharmacy | 90 Bergen St # 1600, Newark, NJ 07103-2425 | 2020-07-21 |
| 1891303616 | Amwell Pharmacy Inc. | Pharmacy | 438 Route 206 Ste 3, Hillsborough, NJ 08844-5525 | 2020-07-17 |
| 1366066235 | Brx LLC | Pharmacy | 250 Chambers Bridge Rd, Brick, NJ 08723 | 2020-06-05 |
| 1982237103 | Holmdel Pharmacy and Deli LLC | Pharmacy | 487 Middle Rd, Hazlet, NJ 07730-2426 | 2020-02-17 |
| 1184254575 | Frrx LLC | Pharmacy | 76 W Gilbert St, Tinton Falls, NJ 07701-4918 | 2020-01-24 |
| 1841820388 | Ewing Pharmacy LLC | Pharmacy | 1400 Parkway Ave Ste A2, Ewing, NJ 08628-3021 | 2020-01-23 |
| 1982240735 | Elite Rx LLC | Pharmacy | 2282 Hamburg Tpke Ste E, Wayne, NJ 07470-6291 | 2019-11-26 |
| 1629626163 | Meadowlands Pharmacy LLC | Pharmacy | 40, Meadowlands Pkway, Secaucus, NJ 07094 | 2019-08-28 |
| 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.