Pathmark Pharmacy

LBN: Pathmark Stores Inc
Pathmark Pharmacy is an health care organization with primary practice located at Kmart Plaza Us Rt 10 , Randolph NJ 07869. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Pathmark Stores Inc can be contacted via phone (973) 361-7532, or through Kijowski, Susan D via phone (201) 571-8326.

Contact Information

Primary practice address
Kmart Plaza Us Rt 10 Randolph NJ 07869
Phone: (973) 361-7532
Fax: (973) 366-5232
Website:
Map and Directions
Authorized official contact:
Name: Kijowski, Susan D
Phone: (201) 571-8326

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X RS2800325300 New Jersey
Suppliers / Pharmacy 333600000X RS002204 New Jersey
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1134220502
LBN Legal business name Pathmark Stores Inc
DBA Doing business as Pathmark Pharmacy
Authorized official Kijowski, Susan D
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 26th, 2006
Last updated Dec 11th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134220502 NPPES
Other 3102756 OTHER ID NUMBER-COMMERCIAL NUMBER
MEDICAID 4300106 OTHER ID NUMBER-COMMERCIAL NUMBER

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