PATHMARK STORES INC (NPI# 1780781542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780781542 |
| Entity Type | Organization |
| Organization Name | PATHMARK STORES INC |
| Other Organization Name | PATHMARK PHARMACY |
| Practice Address |
399 Medford Ave Patchogue NY 11772-1849 |
| Mailing Address |
2 Paragon Dr Montvale NJ 07645-1718 |
| Practice Telephone | 6317582154 |
| Practice Fax Number | 6317583473 |
| 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 | 023215 | NY | Suppliers |
| Y | 333600000X | Pharmacy | 023215 | NY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01742832 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 3319159 | 01 |
| 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 |
399 MEDFORD AVE |
| City | PATCHOGUE |
| State | NY |
| Zip Code | 11772-1849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205447224 | Amita Vipul Patel | Nurse Practitioner | Longlsland Community Hospital, 101 Hospital Rd, Patchogue, NY 11772 | 2020-08-13 |
| 1609491968 | Sanjib Dey | Family Medicine | Brookhaven Nephrology Associates, 260 E. Patchogue-yaphank Rd., Patchogue, NY 11772 | 2020-06-12 |
| 1992297204 | Camila Bueno-sanchez | Student in an Organized Health Care Education/Training Program | 676 S Country Rd, East Patchogue, NY 11772 | 2018-06-01 |
| 1184115859 | Premier Endodontics of Patchogue | Dentist | 44 Medford Avenue, Patchogue, NY 11772 | 2018-05-29 |
| 1801386453 | Franklin Ikechukwu Ugbode | Student in an Organized Health Care Education/Training Program | 100 Hospital Road Suite 201, Patchogue, NY 11772 | 2018-05-18 |
| 1508372335 | Stephanie Vanschaick | Counselor | 450 Waverly Ave Ste 11, Patchogue, NY 11772 | 2017-12-15 |
| 1578074498 | Chrystal Lee Curran | Specialist | 1116 Main Road, Aquebogue, NY 11772 | 2017-10-18 |
| 1013457712 | Candyce Fahner | Registered Nurse | 22 Haig Ave, E Patchogue, NY 11772 | 2017-02-28 |
| 1992251631 | Vanessa Lynn Petoello | Nurse Practitioner | 107 N/ Ocean Ave, Suite G, Patchogue, NY 11772 | 2016-09-01 |
| 1811343809 | Andrew Vanderlofske | Nurse Practitioner | 144 North Ocean Avenue, Patchogue, NY 11772 | 2016-05-09 |
| Find all providers in zip 11772 | ||||
| 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 |
|---|---|---|---|---|
| 1780052001 | Paak Pharmacy Inc | Pharmacy | 689 Medford Ave, Patchogue, NY 11772-1347 | 2015-09-03 |
| 1831483007 | Patchogue Supermarkets LLC | Pharmacy | 95 Sunrise Hwy W, Patchogue, NY 11772-1847 | 2011-06-06 |
| 1376691329 | King Kullen Pharmacy | Pharmacy | 499 Sunrise Hwy Ste 64, Patchogue, NY 11772-2290 | 2007-01-08 |
| 1083625644 | Popular Pharmacy Inc | Pharmacy | 350 E Main St Ste 8, Patchogue, NY 11772-3100 | 2006-08-10 |
| 1275536864 | Caljeb Pharmacy Corp | Pharmacy | 747 Montauk Highway, Patchogue, NY 11772 | 2005-05-27 |
| 1891127346 | Patchogue Pharmacy, Inc | Pharmacy | 176 W Main St, Patchogue, NY 11772-3004 | 2013-08-07 |
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| 1477152627 | Mary Imogene Bassett Hospital | Pharmacy | 231 N Genesee St Fl 2, Utica, NY 13502 | 2020-10-20 |
| 1023625548 | Otc Group LLC | Pharmacy | 2792 Ocean Ave Unit 5, Brooklyn, NY 11229-4730 | 2020-09-29 |
| 1932712817 | Guoyi Lin | Pharmacy | 13351 41st Rd First Floor, Flushing, NY 11355-5837 | 2020-08-28 |
| 1740891001 | Cureatr Inc | Pharmacy | 17 W 20th St Fl 3, New York, NY 10011-3702 | 2020-08-11 |
| 1609486562 | Phils Pill Pharmacy, Inc | Pharmacy | 8387 Woodhaven Blvd, Jamaica, NY 11421-1533 | 2020-08-05 |
| 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.