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PATHMARK STORES INC NPI 1225135098


NPI Information

NPI: 1225135098
Provider Name: PATHMARK STORES INC

Doing Business As: PATHMARK PHARMACY

Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
130 MIDLAND AVE
PORT CHESTER, NY
ZIP 10573
Phone: (914) 937-0996
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PATHMARK STORES INC is a pharmacy in Port Chester, 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 1225135098. The provider is registered as an organization entity type.
The provider Is Doing Business As Pathmark Pharmacy.

The provider's business location address is:

130 MIDLAND AVE
PORT CHESTER, NY
ZIP 10573-916
Phone: (914) 937-0996
Fax: (914) 937-5015

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 3/16/2009.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail PharmacyNo
2332B00000XDurable Medical Equipment & Medical Supplies017766NEW YORKNo
3333600000XPharmacy017766NEW 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100767217MEDICAIDNEW YORK
23376426OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
30636000057MEDICARE 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: 5/5/2024

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