Organization Active NPI

Pathmark Stores Inc

  • Pharmacy
  • New Castle, DE
National Provider Identifier
1295832053
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
A3-0000876 Issued in DE
Legal business name
PATHMARK STORES INC
Practice address
148 Sunset Blvd
New Castle, DE 19720-4100
Phone
(302) 323-9612
Fax
(302) 323-9785
NPI assigned
Sep 20, 2006
Organization subpart
Yes
Parent organization
THE GREAT ATLANTIC & PACIFIC TEA CO INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X A3-0000876 DE
Pharmacy 333600000X A3-0000876 DE Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

148 Sunset Blvd
New Castle, DE 19720-4100

Mailing address

2 Paragon Dr
Montvale, NJ 07645-1718
Phone (201) 573-9700

Other identifiers 2

IdentifierTypeStateIssuer
0802721OtherOTHER ID NUMBER-COMMERCIAL NUMBER
0000117907MedicaidDE

Other names 1

  • PATHMARK PHARMACY Doing business as

National Provider Directory

National Provider Directory
Part of
Great Atlantic Pacific Tea Company Inc

Locations

148 Sunset Blvd
New Castle, DE 19720
Phone (302) 323-9612

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1295832053",
    "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": "148 SUNSET BLVD",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197204100",
            "telephone_number": "302-323-9612",
            "fax_number": "302-323-9785"
        }
    ],
    "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": "2008-06-30",
        "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": "DE",
            "license": "A3-0000876",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "DE",
            "license": "A3-0000876",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "0802721",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000117907",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PATHMARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Castle, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.