NPIMap

Organization Active NPI

Great Atlantic & Pacific Tea Co., Inc.

  • Pharmacy
  • West New York, NJ
National Provider Identifier
1356566749
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
06687 Issued in NJ
Legal business name
GREAT ATLANTIC & PACIFIC TEA CO., INC.
Practice address
19 Ave at Port Imperial
West New York, NJ 07093
Phone
(201) 272-1171
Fax
(201) 867-1976
NPI assigned
Apr 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Authorized official

Name
Susan D Kijowski
Title
Manager, Regulatory Compliance
Phone
(201) 571-8326

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 06687 NJ
Pharmacy 333600000X 06687 NJ Primary

Addresses

Primary practice location

19 Ave at Port Imperial
West New York, NJ 07093

Mailing address

PO Box 416369
Boston, MA 02241-6369

Other identifiers 3

IdentifierTypeStateIssuer
0138382MedicaidNJ
06687OtherNJSTATE LICENSE
3194278OtherNJNCPDP #

Other names 1

  • A & P Pharmacy # 761 Doing business as

National Provider Directory

National Provider Directory

Member of 3

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

Locations

19 Ave At Port Imperial
West New York, NJ 07093
Phone (201) 272-1171

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318291200000",
    "number": "1356566749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416369",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 AVE AT PORT IMPERIAL",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "07093",
            "telephone_number": "201-272-1171",
            "fax_number": "201-867-1976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT ATLANTIC & PACIFIC TEA CO., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2011-10-11",
        "status": "A",
        "authorized_official_last_name": "KIJOWSKI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGER, REGULATORY COMPLIANCE",
        "authorized_official_telephone_number": "201-571-8326"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NJ",
            "license": "06687",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "06687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0138382",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "06687",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP #",
            "identifier": "3194278",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A & P Pharmacy # 761",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West New York, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; 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.