NPIMap

Organization Active NPI

Super Fresh Food Markets, Inc.

Doing business as Super Fresh Pharmacy # 982

  • Pharmacy
  • Philadelphia, PA
National Provider Identifier
1245421890
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
SUPER FRESH FOOD MARKETS, INC.
Doing business as
Super Fresh Pharmacy # 982
Practice address
7162 Ridge Ave
Philadelphia, PA 19128-3250
Phone
(215) 508-7782
Fax
(215) 508-7785
NPI assigned
Aug 8, 2007
Last updated
Nov 9, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
THE GREAT ATLANTIC & PACIFIC TEA CO., INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Authorized official

Name
Mrs. Susan D Kijowski
Title
Pharmacy Specialist
Phone
(201) 571-8326

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PP481751 PA
Pharmacy 333600000X NU Primary

Addresses

Primary practice location

7162 Ridge Ave
Philadelphia, PA 19128-3250

Mailing address

7162 Ridge Ave
Philadelphia, PA 19128-3250
Phone (215) 508-7782

Other identifiers 2

IdentifierTypeStateIssuer
3988877OtherPANCPDP #
8970982OtherPAGROUP, DIV., STORE #

Other names 1

  • Super Fresh Pharmacy # 982 Doing business as

National Provider Directory

National Provider Directory
Part of
The Great Atlantic and

Locations

7162 Ridge Ave
Philadelphia, PA 19128
Phone (215) 483-2124

NPI Registry JSON

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1245421890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7162 RIDGE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191283250",
            "telephone_number": "215-508-7782",
            "fax_number": "215-508-7785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7162 RIDGE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191283250",
            "telephone_number": "215-508-7782",
            "fax_number": "215-508-7785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPER FRESH FOOD MARKETS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE GREAT ATLANTIC & PACIFIC TEA CO., INC.",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-11-09",
        "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",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": "PP481751",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP #",
            "identifier": "3988877",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP, DIV., STORE #",
            "identifier": "8970982",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Super Fresh Pharmacy # 982",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.