Organization Active NPI

Great Atlantic & Pacific Tea Company Inc

  • Pharmacy
  • Midland Park, NJ
National Provider Identifier
1689699241
Registry record updated Oct 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
05493 Issued in NJ
Legal business name
GREAT ATLANTIC & PACIFIC TEA COMPANY INC
Doing business as
A & P PHARMACY
Practice address
136 Lake Ave
Midland Park, NJ 07432-1945
Phone
(201) 612-3070
Fax
(201) 612-3073
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 05493 NJ
Pharmacy 333600000X 05493 NJ Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

136 Lake Ave
Midland Park, NJ 07432-1945

Mailing address

PO Box 416369
Boston, MA 02241-6369

Other identifiers 3

IdentifierTypeStateIssuer
3139284OtherOTHER ID NUMBER-COMMERCIAL NUMBER
7454813OtherNJMEDICAID DME
7454805MedicaidNJ

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": "1689699241",
    "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": "136 LAKE AVE",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321945",
            "telephone_number": "201-612-3070",
            "fax_number": "201-612-3073"
        }
    ],
    "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": "05493",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "05493",
            "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": "3139284",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "7454813",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7454805",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A & P PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midland Park, 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.