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PATHMARK STORES INC NPI 1558461590


NPI Information

NPI: 1558461590
Provider Name: PATHMARK STORES INC

Doing Business As: PATHMARK PHARMACY

Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
100 GREAVES LANE
STATEN ISLAND, NY
ZIP 10308
Phone: (718) 227-0667
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PATHMARK STORES INC is a pharmacy in Staten Island, NY. The provider is 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. PATHMARK STORES INC NPI is 1558461590. The provider is registered as an organization entity type.
The provider Is Doing Business As Pathmark Pharmacy.

The provider's business location address is:

100 GREAVES LANE
STATEN ISLAND, NY
ZIP 10308-171
Phone: (718) 227-0667
Fax: (718) 227-4551

The provider's authorized official is Susan D Kijowski .
The authorized official title is Pharmacy Specialist and has the following contact phone number (201) 571-8326.

The enumeration date for this NPI number is 9/22/2006 and was last updated on 3/13/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical Supplies019261NEW YORKNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
3333600000XPharmacy019261NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13388469OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
20636000022MEDICARE NSCNEW YORK
300986190MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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