NPIMap

Organization Active NPI

Great Atlantic &Pacific Tea Company Inc

  • Pharmacy
  • Boonton, NJ
National Provider Identifier
1396760955
Registry record updated Oct 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
05786 Issued in NJ
Legal business name
GREAT ATLANTIC &PACIFIC TEA COMPANY INC
Practice address
550 Myrtle Ave
Boonton, NJ 07005-1914
Phone
(973) 394-9580
Fax
(973) 394-9588
NPI assigned
Jul 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2011

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 05786 NJ
Pharmacy 333600000X 05786 NJ Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

550 Myrtle Ave
Boonton, NJ 07005-1914

Mailing address

PO Box 416369
Boston, MA 02241-6369

Other identifiers 3

IdentifierTypeStateIssuer
3141657OtherOTHER ID NUMBER-COMMERCIAL NUMBER
8140111OtherNJMEDICAID DME
8140103MedicaidNJ

Other names 1

  • A & P PHARMACY 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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318204800000",
    "number": "1396760955",
    "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": "550 MYRTLE AVE",
            "city": "BOONTON",
            "state": "NJ",
            "postal_code": "070051914",
            "telephone_number": "973-394-9580",
            "fax_number": "973-394-9588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT ATLANTIC &PACIFIC TEA COMPANY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2011-10-10",
        "status": "A",
        "authorized_official_last_name": "KIJOWSKI",
        "authorized_official_first_name": "SUSAN",
        "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": "05786",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "05786",
            "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": "3141657",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "8140111",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8140103",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A & P PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boonton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.