Organization · Type 2 NPI

Pathmark Stores Inc

Pharmacy · Philadelphia, PA

NPI number 1760589535 Active

Practice location

4160 Monument Rd
Philadelphia, PA 19131-1726

Call (215) 879-8830 Map

Fax (215) 879-7466

Mailing address

2 Paragon Dr
Montvale, NJ 07645-1718

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	PP411819L (PA)
Pharmacy Primary	333600000X	PP411819L (PA)

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…

3 other providers at this address

Other pharmacy providers in Philadelphia

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NPI record

NPI: 1760589535
Entity type: Organization (Type 2)
Issued: Sep 20, 2006
Last updated: Jun 27, 2008
Status: Active
Subpart: Yes of The Great Atlantic & Pacific Tea Co 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 1760589535

Pathmark Stores Inc's National Provider Identifier is 1760589535, issued on Sep 20, 2006. The primary taxonomy on file is Pharmacy (333600000X), and the practice location is in Philadelphia, PA. The record was last updated on Jun 27, 2008.