Great Atlantic & Pacific Tea Co., Inc.
Organization Active NPI Pharmacy · Park Ridge, NJ
NPI 1104942259 · NPPES record last updated Oct 10, 2011
Key facts
- NPI
- 1104942259
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 06692 (NJ)
- Legal business name
- GREAT ATLANTIC & PACIFIC TEA CO., INC.
- Practice address
- 199 Kinderkamack Rd
Park Ridge, NJ 07656-1335 - Phone
- (201) 391-3232
- Fax
- (201) 930-9672
- NPI assigned
- Mar 21, 2007
- Organization subpart
- No
Authorized official
- Name
- Susan D Kijowski
- Title
- Manager, Regulatory Compliance
- Phone
- (201) 571-8326
Member of 3
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 06692 | NJ | |
| Pharmacy | 333600000X | 06692 | NJ | Yes |
Addresses
Primary practice location
199 Kinderkamack Rd
Park Ridge, NJ 07656-1335
Mailing address
PO Box 416369
Boston, MA 02241-6369
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8186804 | Medicaid | NJ | |
| 3194204 | Other | NJ | NCPDP # |
| 8186812 | Other | NJ | MEDICAID DME |
Other names
- A&P Pharmacy # 664
Other providers in Park Ridge, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.