Organization · Type 2 NPI

Pathmark Stores Inc

Pharmacy · Staten Island, NY

NPI number 1558461590 Active

Practice location

100 Greaves Lane
Staten Island, NY 10308-2171

Call (718) 227-0667 Map

Fax (718) 227-4551

Mailing address

2 Paragon Dr
Montvale, NJ 07645-1718

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	019261 (NY)
Pharmacy Primary	333600000X	019261 (NY)
Community/Retail Pharmacy	3336C0003X	None listed

Pharmacy: A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is lo…

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NPI record

NPI: 1558461590
Entity type: Organization (Type 2)
Issued: Sep 22, 2006
Last updated: Mar 13, 2009
Status: Active
Subpart: Yes of The Great Atlantic & Pacific Tea Company, Inc.

Other names

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Pathmark Pharmacy · doing business as

Authorized official

Susan D Kijowski
Pharmacy Specialist
(201) 571-8326

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1558461590

Pathmark Stores Inc's National Provider Identifier is 1558461590, issued on Sep 22, 2006. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Staten Island, NY. The record was last updated on Mar 13, 2009.