Super Fresh Food Markets Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

04869 Issued in NJ

Legal business name

SUPER FRESH FOOD MARKETS INC

Doing business as

Super Fresh Pharmacy

Practice address

709 S Broadway
Pennsville, NJ 08070-9655

Phone

(856) 935-7732

Fax

(856) 935-4752

NPI assigned

Jul 13, 2006

Organization subpart

Yes

Parent organization

THE GREAT ATLANTIC AND PACIFIC TEA COMPANY INCAs reported in NPPES

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

Authorized official

Name

Susan Kijowski

Title

Pharmacy Specialist

Phone

(201) 571-8326

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• SUPER FRESH PHARMACY Doing business as

Tax ID family

Super Fresh Food Markets Inc5 organizations share this tax ID, including this one

Part of

Great Atlantic Pacific Tea Company Inc

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Super Fresh Food Markets, Inc.

  • Pharmacy
  • Montvale, NJ
  • NPI 1629350251
  NPD tax ID
• Super Fresh Food Markets Inc

  dba Super Fresh Pharmacy

  • Pharmacy
  • Newark, DE
  • NPI 1063437614
  NPD tax ID
• Super Fresh Food Markets Inc

  dba Super Fresh Pharmacy

  • Pharmacy
  • Bristol, PA
  • NPI 1538184189
  NPD tax ID
• Super Fresh Food Markets, Inc.

  dba Super Fresh Pharmacy # 804

  • Pharmacy
  • Lansdale, PA
  • NPI 1295950350
  NPD tax ID

Locations

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195344000000",
    "number": "1245255801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 S BROADWAY",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080709655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 S BROADWAY",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080709655",
            "telephone_number": "856-935-7732",
            "fax_number": "856-935-4752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPER FRESH FOOD MARKETS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE GREAT ATLANTIC AND PACIFIC TEA COMPANY INC",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-11-18",
        "status": "A",
        "authorized_official_last_name": "KIJOWSKI",
        "authorized_official_first_name": "SUSAN",
        "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": "NJ",
            "license": "04869",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "04869",
            "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": "6118801",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "6118810",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3135109",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUPER FRESH PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristin Lawrence Shute, CCC-SLP
• Katherine Celeste Soltanuk
• Gina M Sparacio, MS, LAC, LCADC, CCS,
• Susan Ann Sparks-Cahill, PTA DEJ2-0000877
• Spintrach Pharmacy Inc
• James J. Susack Jr., D.M.D., PC
• The Salem County Center for Autism
• Theresa C. Fleming, O.D., P.C.
• Township of Pennsville (Pennsville Township Ambulance Dept)
• Natalie Anne Trawinski, PA-C

• Pharmacy in Pennsville, NJ
• Providers in Pennsville, NJ by specialty
• Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2007; 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.