Pathmark Pharmacy

LBN: Pathmark Stores Inc
Pathmark Pharmacy is an health care organization with primary practice located at 407 Valley St , South Orange NJ 07079-2807. 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) 762-5044, or through Kijowski, Susan D via phone (201) 571-8326.

Contact Information

Primary practice address
407 Valley St South Orange NJ 07079-2807
Phone: (973) 762-5044
Fax: (973) 378-3449
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 RS003807 New Jersey
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1568569325
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 20th, 2006
Last updated Dec 10th, 2008 - about 16 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 1568569325 NPPES
New Jersey MEDICAID 4301005
New Jersey Other 3102807

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