Pathmark Stores Inc

Pharmacy · Randolph, NJ

Organization Active NPI

NPI number 1134220502

Practice location

Kmart Plaza Us RT 10
Randolph, NJ 07869
Phone
(973) 361-7532
Fax
(973) 366-5232

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NPI record

NPI
1134220502
Entity type
Organization (Type 2)
Enumeration date
September 26, 2006
Last updated
December 11, 2008
Organization subpart
Yes
Parent organization
The Great Atlantic & Pacific Tea Co

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pharmacy Primary 333600000X RS002204 NJ
Durable Medical Equipment & Medical Supplies 332B00000X RS2800325300 NJ
Community/Retail Pharmacy 3336C0003X — —

Mailing address

2 Paragon Dr
Montvale, NJ 07645-1718
Phone
(201) 573-9700
Fax
(291) 571-8326

Authorized official

Name
Susan D Kijowski
Title
Pharmacy Specialist
Phone
(201) 571-8326

Other names

  • Pathmark Pharmacy

About Pathmark Stores Inc

Pathmark Stores Inc is a healthcare organization registered in the NPI registry with the primary taxonomy Pharmacy (code 333600000X). The practice location is Kmart Plaza Us RT 10, Randolph, NJ 07869. The NPI number 1134220502 was assigned on September 26, 2006 and the record was last updated on December 11, 2008.

Pathmark Stores Inc lists 2 licenses in the registry: #RS002204 (NJ) for Pharmacy; #RS2800325300 (NJ) for Durable Medical Equipment & Medical Supplies. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Susan D Kijowski, Pharmacy Specialist.

Frequently asked questions

What is the NPI number of Pathmark Stores Inc?

The NPI number is 1134220502.

What is the phone number of Pathmark Stores Inc?

The phone number listed for the practice location is (973) 361-7532.

Where is Pathmark Stores Inc located?

Kmart Plaza Us RT 10, Randolph, NJ 07869.

What is the taxonomy code for Pathmark Stores Inc?

The primary taxonomy code is 333600000X – Pharmacy; 2 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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