Pathmark Stores INC

NPI #1326145186 in Holbrook, New York

Provider Information

NPI Number: 1326145186
Entity Type: Organization
Organization Name: Pathmark Stores INC
Subpart: Yes (part of a larger organization)
Parent Organization: THE GREAT ATLANTIC & PACIFIC TEA CO INC
Primary Specialty: Pharmacy
Enumeration Date: Sep 20, 2006
Last Updated: Oct 8, 2010

Practice Location

Address: 5801 SUNRISE HWY
City: Holbrook
State: New York
ZIP Code: 11741-4841
Phone: (631) 567-6969

Authorized Official

Name: SUSAN D KIJOWSKI
Title: REGULATORY COMPLIANCE SPECIALIST
Phone: (201) 571-8326

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy	3336C0003X
Durable Medical Equipment & Medical Supplies	332B00000X
Pharmacy	333600000X	Primary

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