NPIMap

Organization Active NPI

The Great Atlantic & Pacific Tea Co., Inc.

  • Pharmacy
  • Old Tappan, NJ
National Provider Identifier
1477751675
Registry record updated Mar 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
06711 Issued in NJ
Legal business name
THE GREAT ATLANTIC & PACIFIC TEA CO., INC.
Practice address
216 Old Tappan Road
Old Tappan, NJ 07675
Phone
(201) 391-0639
Fax
(201) 391-1845
NPI assigned
Jul 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2009

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

Authorized official

Name
Mrs. Susan D Kijowski, BS
Title
Pharmacy Specialist
Phone
(201) 571-8326

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 06711 NJ
Pharmacy 333600000X 06711 NJ Primary
Mail Order Pharmacy 3336M0002X RS00671100 NJ

Addresses

Primary practice location

216 Old Tappan Road
Old Tappan, NJ 07675

Mailing address

216 Old Tappan Road
Old Tappan, NJ 07675
Phone (201) 391-0639

Other identifiers 3

IdentifierTypeStateIssuer
D09109200OtherNJNJ STATE CDS LICENSE
RS00671100OtherNJNJ STATE PHARMACY LICENSE
3194470OtherNJNCPDP #

Other names 1

  • LIVE BETTER PHARMACY # 441 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": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237766400000",
    "number": "1477751675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 OLD TAPPAN ROAD",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "07675",
            "telephone_number": "201-391-0639",
            "fax_number": "201-391-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 OLD TAPPAN ROAD",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "07675",
            "telephone_number": "201-391-0639",
            "fax_number": "201-391-1845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GREAT ATLANTIC & PACIFIC TEA CO., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2009-03-23",
        "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",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NJ",
            "license": "06711",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "06711",
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "NJ",
            "license": "RS00671100",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ STATE CDS LICENSE",
            "identifier": "D09109200",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ STATE PHARMACY LICENSE",
            "identifier": "RS00671100",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP #",
            "identifier": "3194470",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIVE BETTER PHARMACY # 441",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Old Tappan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2009; 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.