Pathmark Stores Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

PP411788L Issued in PA

Legal business name

PATHMARK STORES INC

Doing business as

PATHMARK PHARMACY

Practice address

8716 Frankford Ave
Philadelphia, PA 19136-1315

Phone

(215) 331-0200

Fax

(215) 338-7788

NPI assigned

Sep 20, 2006

Organization subpart

Yes

Parent organization

THE GREAT ATLANTIC & PACIFIC TEA CO INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Susan D Kijowski

Title

Pharmacy Specialist

Phone

(201) 571-8326

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• PATHMARK PHARMACY Doing business as

Part of

Great Atlantic Pacific Tea Company Inc

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dale Fischer Blum, RPH

  • Pharmacist
  • Phila, PA
  • NPI 1629247903
  NPD (past)
• Michael Anthony Semeraro, BSPH

  • Pharmacist
  • Yardley, PA
  • NPI 1275799421
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1215034087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PARAGON DR",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451718",
            "telephone_number": "201-573-9700",
            "fax_number": "201-571-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8716 FRANKFORD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191361315",
            "telephone_number": "215-331-0200",
            "fax_number": "215-338-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHMARK STORES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE GREAT ATLANTIC & PACIFIC TEA CO INC",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "KIJOWSKI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHARMACY SPECIALIST",
        "authorized_official_telephone_number": "201-571-8326"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": "PP411788L",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP411788L",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017374600011",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3906394",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PATHMARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sami Milan Pathak, MD
• Sonam Pathak
• Jay Sriram Pathmanathan, M.D., PH.D.
• Pathmark Stores Inc
• Pathmark Stores Inc
• Pathmark Stores Inc
• Pathmark Stores Inc
• Pathology at Jeanes
• Pathway2Healthcare
• Pathways PA

• Pharmacy in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.