Pathmark Stores Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

RS02202 Issued in NJ

Legal business name

PATHMARK STORES INC

Doing business as

Pathmark Pharmacy

Practice address

2110 RT 130
Beverly, NJ 08010

Phone

(609) 871-1550

Fax

(609) 877-7719

NPI assigned

Sep 22, 2006

Last updated

Sep 29, 2008By the provider in NPPES

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 2

Addresses

Other names 1

• PATHMARK PHARMACY Doing business as

Part of

Great Atlantic Pacific Tea

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Great Atlantic & Pacific Tea Company Inc

  dba A & P Pharmacy

  • Pharmacy
  • Wall Township, NJ
  • NPI 1790700359

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anthony Affigato, R.PH.

  • Pharmacist
  • Beverly, NJ
  • NPI 1831451418
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1285733253",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 RT 130",
            "city": "BEVERLY",
            "state": "NJ",
            "postal_code": "08010",
            "telephone_number": "609-871-1550",
            "fax_number": "609-877-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHMARK STORES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE GREAT ATLANTIC & PACIFIC TEA CO INC",
        "enumeration_date": "2006-09-22",
        "last_updated": "2008-09-29",
        "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": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "RS02202",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PATHMARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mia Haskins
• Jasmine Kiara Jackson, MS.ED., LMHC, LPC
• Nadine Jacobs
• National Mentor Healthcare, LLC (New Jersey MENTOR)
• Evelyn Pappoe, LMFT
• Precious One Home Healthcare Services LLC
• Elizabeth Purdy, LSW
• Rha Health Services NJ LLC
• Root to Vine Therapy
• Queenella Wisner

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.