PATHMARK STORES INC (NPI# 1174620934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174620934 |
| Entity Type | Organization |
| Organization Name | PATHMARK STORES INC |
| Other Organization Name | PATHMARK PHARMACY |
| Practice Address |
498 E 30th St Paterson NJ 07504-2133 |
| Mailing Address |
2 Paragon Dr Montvale NJ 07645-1718 |
| Practice Telephone | 9732789339 |
| Practice Fax Number | 9732780199 |
| Mailing Telephone | 2015739700 |
| Mailing Fax Number | 2015718335 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-12-10 |
| Authorized Official Name | SUSAN D KIJOWSKI (PHARMACY SPECIALIST) |
| Authorized Official Telephone | 2015718326 |
| Is Organization Subpart | Y |
| Parent Organization Name | THE GREAT ATLANTIC & PACIFIC TEA CO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | RS2800325300 | NJ | Suppliers |
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | RS004557 | NJ | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 4534204 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 3132595 | 01 |
| Other Name | Type Code |
|---|---|
| PATHMARK PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770684144 | Pathmark Stores Inc | Pharmacy | 195 Rockland Ctr, Nanuet, NY 10954-2956 | 2006-09-26 |
| 1134220502 | Pathmark Stores Inc | Durable Medical Equipment & Medical Supplies | Kmart Plaza Us Rt 10, Randolph, NJ 07869 | 2006-09-26 |
| 1043311418 | Pathmark Stores Inc | Pharmacy | Route 440 and Kellogg St, Jersey City, NJ 07305 | 2006-09-26 |
| 1548360589 | Pathmark Stores Inc | Pharmacy | 405 Rt 17, Hackensack, NJ 07601 | 2006-09-22 |
| 1285733253 | Pathmark Stores Inc | Pharmacy | 2110 Rt 130, Beverly, NJ 08010 | 2006-09-22 |
| 1407956436 | Pathmark Stores Inc | Durable Medical Equipment & Medical Supplies | 979 Church Rd, Cherry Hill, NJ 08002-1301 | 2006-09-22 |
| 1679673602 | Pathmark Stores Inc | Durable Medical Equipment & Medical Supplies | 759 Rt 15 South, Lake Hopatcong, NJ 07849 | 2006-09-22 |
| 1558461590 | Pathmark Stores Inc | Durable Medical Equipment & Medical Supplies | 100 Greaves Lane, Staten Island, NY 10308-2171 | 2006-09-22 |
| 1588764518 | Pathmark Stores Inc | Pharmacy | 35 Lackawanna Plaza, Montclair, NJ 07042 | 2006-09-22 |
| 1851491898 | Pathmark Stores Inc | Pharmacy | 10 Triangle 17 Plaza, Ramsey, NJ 07446 | 2006-09-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Retail Food Store | PATHMARK STORES INC | 5145 NESCONSET HWY PORT JEFFERSON STA NY 11776 |
| Street Address |
498 E 30TH ST |
| City | PATERSON |
| State | NJ |
| Zip Code | 07504-2133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902147051 | Great Falls Dialysis LLC | Clinic/Center | 498 E 30th St, Paterson, NJ 07504-2133 | 2013-03-13 |
| 1346470325 | Food Basics, Inc | Durable Medical Equipment & Medical Supplies | 498 E 30th St, Paterson, NJ 07504-2133 | 2009-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881051696 | Jacqueline Yvonne Ghee | Social Worker | 612 14th Ave., Clifton, NJ 07504 | 2016-01-25 |
| 1962723429 | Karen L Douglas | Counselor | 253 18th Avenue, Paterson, NJ 07504 | 2010-06-18 |
| 1235303934 | Cherryl Lewis-berry | Licensed Practical Nurse | 284 Wall Ave, Patterson, NY 07504 | 2008-04-15 |
| 1760672380 | Jonathan Bruce Spages | Chiropractor | 234 Mclean Blvd, Paterson, NJ 07504 | 2007-07-30 |
| 1417147257 | David Neal Rendelstein | Chiropractor | 234 Mclean Blvd, Paterson, NJ 07504 | 2007-07-27 |
| 1346309754 | Nart Tsay | Chiropractor | 567 Park Ave, Paterson, NJ 07504 | 2006-12-08 |
| 1154566198 | Rehan Hassanin Seyam | Counselor | 152 Derrom Ave, Paterson, NJ 07504-1003 | 2008-12-04 |
| 1780134783 | Bryant Flores | Chiropractor | 567 Park Ave, Paterson, NJ 07504-1006 | 2016-10-13 |
| 1508928748 | Kamel Kazan | Chiropractor | 567 Park Ave, Paterson, NJ 07504-1006 | 2006-12-14 |
| 1174021596 | Echo Care LLC | Home Health | 244 Wall Ave, Paterson, NJ 07504-1016 | 2018-01-31 |
| Find all providers in zip 07504 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | 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 located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740780980 | Icp2 LLC | Pharmacy | 661main Street, Paterson, NJ 07503 | 2018-02-14 |
| 1477092039 | Rhk Pharmacy Management LLC | Pharmacy | 680 Broadway Ste 108, Paterson, NJ 07514-1526 | 2017-02-15 |
| 1609910017 | Lb Pharmacy Inc | Pharmacy | 448 Chamberlain Ave, Paterson, NJ 07522-1009 | 2007-02-18 |
| 1639212533 | Paterson Drug Inc | Pharmacy | 430 Madison Ave, Paterson, NJ 07524-2728 | 2007-02-14 |
| 1942364195 | Community Care Pharmacy Inc | Pharmacy | 55 North Main St., Community Care Pharmacy, Paterson, NJ 07522 | 2006-12-21 |
| 1861555153 | Hospital Pharmacy | Pharmacy | 544 Market St, Paterson, NJ 07513-1426 | 2006-12-18 |
| 1871660944 | Billstra Pharmacy LLC | Pharmacy | 608 21st Ave, Paterson, NJ 07513-1261 | 2006-11-30 |
| 1568567428 | Farmacias Del Pueblo LLC | Pharmacy | 992-994 Madison Ave, Paterson, NJ 07501 | 2006-09-14 |
| 1629094255 | Pb Pharmacy | Pharmacy | 222 Union Avenue, Paterson, NJ 07502 | 2006-07-15 |
| 1558303339 | Mcdermott Drug Corp | Pharmacy | 433 Union Ave, Paterson, NJ 07502-1917 | 2006-06-13 |
| Find all providers in PATERSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.