PATHMARK STORES, INC. (NPI# 1861623407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861623407 |
| Entity Type | Organization |
| Organization Name | PATHMARK STORES, INC. |
| Other Organization Name | PATHMARK PHARMACY # 171 |
| Practice Address |
2660 Hylan Blvd Staten Island NY 10306-4355 |
| Mailing Address |
2 Paragon Dr Montvale NJ 07645-1718 |
| Practice Telephone | 7186682972 |
| Practice Fax Number | 7186682974 |
| Mailing Telephone | 2015739700 |
| Mailing Fax Number | 2015718335 |
| Enumeration Date | 2009-07-30 |
| Last Update Date | 2009-09-04 |
| 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 | 332B00000X | Durable Medical Equipment & Medical Supplies | 029643 | NY | Suppliers |
| Y | 333600000X | Pharmacy | 029643 | NY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | STATE LICENSE | 029643 | 01 |
| NY | DEA | FP1556072 | 01 |
| Other Name | Type Code |
|---|---|
| PATHMARK PHARMACY # 171 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083884928 | Pathmark Stores, Inc. | Long Term Care Hospital | 16417 Grand Central Pkwy, Jamaica, NY 11432-1810 | 2008-03-06 |
| 1134226905 | Pathmark Stores, Inc. | Durable Medical Equipment & Medical Supplies | 237-239 Cherry St, New York, NY 10002-0000 | 2006-09-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | PATHMARK STORES, INC. | 19 Spear Road, Suite 310, Ramsey, New Jersey 07446 |
| Connecticut Business Registrations | PATHMARK STORES, INC. | 2 Paragon Drive, Montvale, NJ 07645 |
| Street Address |
2660 HYLAN BLVD |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10306-4355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053418814 | Pathmark Stores Inc | Pharmacy | 2660 Hylan Blvd, Staten Island, NY 10306-4355 | 2006-09-20 |
| 1245507052 | William Leung | Pharmacist | 2660 Hylan Blvd, Staten Island, NY 10306-4360 | 2011-11-22 |
| 1083904486 | Pathmark | Pharmacist | 2660 Hylan Blvd, Staten Island, NY 10306-4360 | 2011-04-19 |
| 1255504130 | Keith Joseph Swanson | Pharmacist | 2660 Hylan Blvd, Staten Island, NY 10306-4355 | 2008-04-11 |
| 1104099977 | King Kullen Pharmacies Corp | Pharmacy | 2660 Hylan Blvd, Staten Island, NY 10306 | 2008-04-11 |
| 1578735536 | Elaine D Lanham | Pharmacist | 2660 Hylan Blvd, Staten Island, NY 10306 | 2008-03-31 |
| 1538330634 | Rupal C Patel | Pharmacist | 2660 Hylan Blvd, Staten Island, NY 10306-4355 | 2008-03-17 |
| 1144491531 | Kimberly Sansevero | Pharmacist | 2660 Hylan Blvd, Staten Island, NY 10306-4355 | 2008-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134737372 | Nancy Burns | Counselor | 345 Guyon Ave # 14, Staten Island, NY 10306 | 2020-07-14 |
| 1710537642 | Happy Island Senior Center LLC | Clinic/Center | 555 Greeley Ave, Staten Island, NY 10306 | 2019-09-12 |
| 1215580055 | Keann Pender | Counselor | 345 Guyon Ave Rm 14, Staten Island, NY 10306 | 2019-07-22 |
| 1346751435 | Amanda Nicole Lewis | Speech-Language Pathologist | 465 New Dorp Lane, The Richard H. Hungerford School, Staten Island, NY 10306 | 2017-10-17 |
| 1649793142 | Olympia Services Inc | Radiology | 1913 Olympia Blvd., Staten Island, NY 10306 | 2017-07-18 |
| 1265961601 | A & S Educational Technology Inc. | Early Intervention Provider Agency | 99 Sydney Pl, Staten Island, NY 10306 | 2017-06-08 |
| 1124489638 | Prospect Kids, LLC | Early Intervention Provider Agency | 21 Kayla Court, Staten Island, NY 10306 | 2016-03-10 |
| 1124498407 | Tatyana Kateva | Registered Nurse | 1975 Hylan Blvd Suite 1, Staten Island, NY 10306 | 2015-09-30 |
| 1336536275 | Natallia Verbitsky | Occupational Therapist | 165 Twombly Ave, Staten Island, NY 10306 | 2015-04-17 |
| 1922491745 | Evan Ross Cohen | Dentist | 1975 Hylan Blvd., Unit #2, Hylan Dental Arts, Staten Island, NY 10306 | 2015-03-18 |
| Find all providers in zip 10306 | ||||
| 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 |
|---|---|---|---|---|
| 1609351956 | Ismaeel Pharmacy Inc | Pharmacy | 280 Broadway # Store1, Staten Island, NY 10310-2055 | 2018-10-02 |
| 1487132064 | Bay Rx Inc | Pharmacy | 47 Broad St, Staten Island, NY 10304-2608 | 2018-08-05 |
| 1053805788 | Castleton Chemists LLC | Pharmacy | 831 Castleton Ave, Staten Island, NY 10310 | 2018-06-16 |
| 1275043200 | Gvm Pharmacy Inc | Pharmacy | 203 Old Town Rd, Staten Island, NY 10305-1415 | 2017-10-04 |
| 1881068971 | Enjoy Pharmaceutical Services | Pharmacy | 3927 Amboy Rd, Staten Island, NY 10308-2421 | 2015-11-30 |
| 1851762256 | Regal Remedies Rx Inc | Pharmacy | 19a Olympia Blvd, Staten Island, NY 10305-4309 | 2015-10-12 |
| 1477923266 | Mannix Family Market At Veterans Road LLC | Pharmacy | 3010 Veterans Rd W, Staten Island, NY 10309-2510 | 2015-10-06 |
| 1407285216 | Richmond Valley Pharmacy Inc | Pharmacy | 4888 Arthur Kill Rd, Staten Island, NY 10309-2633 | 2013-11-02 |
| 1003250614 | Health Aid Pharmacy II Inc | Pharmacy | 1781 Richmond Rd, Staten Island, NY 10306-2524 | 2013-04-25 |
| 1982940763 | Staten Island Pharmacy Inc. | Pharmacy | 1807 Victory Blvd, Staten Island, NY 10314-3515 | 2012-12-23 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10306 |
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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.