NPIMap

Organization Active NPI

Super Fresh Food Markets, Inc.

  • Pharmacy
  • Lansdale, PA
National Provider Identifier
1295950350
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PP481110 Issued in PA
Legal business name
SUPER FRESH FOOD MARKETS, INC.
Practice address
616 E Main St
Lansdale, PA 19446-2964
Phone
(215) 855-5606
Fax
(215) 855-6097
NPI assigned
Apr 16, 2007
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 14, 2007

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

Authorized official

Name
Ms. Carol J. Dinicolantonio, R.PH. MBA
Title
Sr. Director, Pharmacy
Phone
(201) 571-8334

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PP481110 PA
Pharmacy 333600000X PP481110 PA Primary
Community/Retail Pharmacy 3336C0003X PP481110 PA

Addresses

Primary practice location

616 E Main St
Lansdale, PA 19446-2964

Mailing address

616 E Main St
Lansdale, PA 19446-2964
Phone (215) 855-5606

Other identifiers 3

IdentifierTypeStateIssuer
3987572OtherPANCPDP #
1007725100056MedicaidPA
PP481110OtherPASTATE LICENSE

Other names 1

  • Super Fresh Pharmacy # 804 Doing business as

National Provider Directory

National Provider Directory
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.

Locations

616 E Main St
Lansdale, PA 19446
Phone (215) 855-5606

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": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1295950350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 E MAIN ST",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194462964",
            "telephone_number": "215-855-5606",
            "fax_number": "215-855-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 E MAIN ST",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194462964",
            "telephone_number": "215-855-5606",
            "fax_number": "215-855-6097"
        }
    ],
    "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": "2007-04-16",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "DINICOLANTONIO",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "SR. DIRECTOR, PHARMACY",
        "authorized_official_telephone_number": "201-571-8334",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.PH. MBA"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": "PP481110",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "PA",
            "license": "PP481110",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP481110",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP #",
            "identifier": "3987572",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007725100056",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PP481110",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Super Fresh Pharmacy # 804",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lansdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.