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PATHMARK STORES INC NPI 1881791648


NPI Information

NPI: 1881791648
Provider Name: PATHMARK STORES INC

Doing Business As: PATHMARK PHARMACY

Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
1351 FOREST AVE
STATEN ISLAND, NY
ZIP 10302
Phone: (718) 448-6758
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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 1881791648. The provider is registered as an organization entity type.
The provider Is Doing Business As Pathmark Pharmacy.

The provider's business location address is:

1351 FOREST AVE
STATEN ISLAND, NY
ZIP 10302-027
Phone: (718) 448-6758
Fax: (718) 981-0540

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 9/20/2006 and was last updated on 3/12/2009.


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 Supplies013354NEW YORKNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
3333600000XPharmacy013354NEW 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
13313981OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
200264764MEDICAIDNEW YORK
30636000065MEDICARE NSCNEW 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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