NPIMap

Organization Active NPI

The Great Atlantic and Pacific Tea Company Inc

Doing business as Super Fresh Pharmacy

  • Community/Retail Pharmacy
  • Baltimore, MD
National Provider Identifier
1407871056
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
THE GREAT ATLANTIC AND PACIFIC TEA COMPANY INC
Doing business as
Super Fresh Pharmacy
Practice address
2401 Cleanleigh Dr
Baltimore, MD 21234-6808
Phone
(410) 663-9602
Fax
(410) 663-9608
NPI assigned
Jul 13, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Susan Kijowski
Title
Pharmacy Specialist
Phone
(201) 571-8326

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X P01966 MD
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

2401 Cleanleigh Dr
Baltimore, MD 21234-6808

Mailing address

PO Box 23069
Newark, NJ 07189-0001

Other identifiers 1

IdentifierTypeStateIssuer
2120892OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • SUPER FRESH PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Great Atlantic Pacific Tea Company Inc32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Locations

2401 Cleanleigh Dr
Parkville, MD 21234
Phone (410) 663-9602

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": "1757548800000",
    "number": "1407871056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23069",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071890001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 CLEANLEIGH DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212346808",
            "telephone_number": "410-663-9602",
            "fax_number": "410-663-9608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GREAT ATLANTIC AND PACIFIC TEA COMPANY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "KIJOWSKI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PHARMACY SPECIALIST",
        "authorized_official_telephone_number": "201-571-8326"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MD",
            "license": "P01966",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2120892",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUPER FRESH PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.