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Active NPI 1548360589 Organization (Entity Type 2) Subpart Facility

Pathmark Stores Inc

Pharmacy • Hackensack, NJ

Parent Organization: The Great Atlantic And Pacific Tea Co Inc

About Pathmark Stores Inc NPI 1548360589 Summary

Pathmark Stores Inc is a verified healthcare organization specializing in Pharmacy operating in Hackensack, NJ. Located at 405 RT 17, this facility provides patient care and medical services under National Provider Identifier (NPI) 1548360589.

Pathmark Stores Inc operates as a subpart facility of The Great Atlantic And Pacific Tea Co Inc. Administrative operations and authorized compliance are overseen by Susan Kijowski (Pharmacy Specialist).

Facility Location & Contact Primary Location

Facility Address

405 Rt 17

Hackensack, NJ 07601

Telephone 2014870145
Fax 2015251252

Authorized Official Information

Authorized Contact Name

Susan Kijowski

Title / Role

Pharmacy Specialist

Official Telephone

2015718326

Facility Classifications & Specialties

Pharmacy Primary Taxonomy

NUCC Taxonomy Code: 333600000X

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.

Durable Medical Equipment & Medical Supplies

NUCC Taxonomy Code: 332B00000X

A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Pharmacy - Community/Retail Pharmacy

NUCC Taxonomy Code: 3336C0003X

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events
NPI Profile Active March 11, 2009

NPI status registered as active in NPPES database

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Updated Practice Location March 11, 2009

Registered at 405 RT 17, HACKENSACK, NJ 07601 (Tel: 2014870145)

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Updated Business Mailing Address March 11, 2009

Registered at 2 PARAGON DR, MONTVALE, NJ 076451718 (Tel: 2015739700)

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Organization / Clinic Name Updated March 11, 2009

Operating as PATHMARK STORES INC

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 11, 2009

Durable Medical Equipment & Medical Supplies (License #RS2800240900 in NJ)

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Initial NPI Registration & Enumeration September 22, 2006

First registered as active Healthcare Organization in NPPES Database.

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NPI Organization Metadata

NPI Number: 1548360589
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: September 22, 2006
Last Update: March 11, 2009

Mailing Address

2 Paragon Dr

Montvale, NJ 076451718

Phone: 2015739700

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.