NPIMap

Organization Active NPI

Pathmark Stores Inc

  • Pharmacy
  • Eatontown, NJ
National Provider Identifier
1831296698
Registry record updated Aug 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
RS002205 Issued in NJ
Legal business name
PATHMARK STORES INC
Practice address
50 State Route 36
Eatontown, NJ 07724-2508
Phone
(732) 542-6204
Fax
(732) 389-7434
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2007

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

Authorized official

Name
Mindi Norelli
Title
Admin
Phone
(732) 499-3313

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X RS002205 NJ Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

50 State Route 36
Eatontown, NJ 07724-2508

Mailing address

200 Milik St
M115
Carteret, NJ 07008-1102

Other identifiers 2

IdentifierTypeStateIssuer
3102770OtherOTHER ID NUMBER-COMMERCIAL NUMBER
4300700MedicaidNJ

Other names 1

  • PATHMARK PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pathmark Pharmacy10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

50 State Route 36
Eatontown, NJ 07724
Phone (732) 542-6204

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186617600000",
    "number": "1831296698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILIK ST",
            "address_2": "M115",
            "city": "CARTERET",
            "state": "NJ",
            "postal_code": "070081102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 STATE ROUTE 36",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077242508",
            "telephone_number": "732-542-6204",
            "fax_number": "732-389-7434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHMARK STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-08-09",
        "status": "A",
        "authorized_official_last_name": "NORELLI",
        "authorized_official_first_name": "MINDI",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "732-499-3313"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "RS002205",
            "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": "3102770",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4300700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PATHMARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eatontown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; 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.