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Contact Information

PATHMARK STORES INC
2110 RT 130
BEVERLY, NJ08010
 Phone: 609-871-1550
 Fax: 609-877-7719
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PATHMARK STORES INC

NPI # 1285733253
LBN Legal business name PATHMARK STORES INC
Authorized official SUSAN KIJOWSKI - (PHARMACY SPECIALIST)
Entity Organization
Organization subpart 1 Yes
Enumeration date 09/22/2006
Last updated 09/29/2008 - About 18 years ago
Identifiers
NJ License # RS02202
NJ Medicaid 4291409
Other 3102720 OTHER ID NUMBER-COMMERCIAL NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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