MEDICARE: GREAT ATLANTIC & PACIFIC TEA COMPANY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	05266	NJ
2	3336C0003X	Community/Retail Pharmacy
3	333600000X	Pharmacy	05266	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3137622	OTHER	OTHER ID NUMBER-COMMERCIAL NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598780157
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREAT ATLANTIC & PACIFIC TEA COMPANY INC

Provider Business Mailing Address
First Line	:	PO BOX 416369
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02241-6369
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 BOULEVARD
Second Line	:
City	:	KENILWORTH
State	:	NJ
Zip	:	07033-1719
Country	:	US
Telephone Number	:	908-241-5421
Fax Number	:	908-241-8623

Authorized Official
Title or Position	:	MANAGER, REGULATORY COMPLIANCE
Name	:	SUSAN KIJOWSKI
Credential	:
Telephone Number	:	201-571-8326

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	10/11/2011

Similar Medicare Providers

1538414271 — DANA MAGNUSSON PHARMD
Practice Location Address:

801 BOULEVARD
KENILWORTH, NJ
07033-1719

Practice Phone: 908-241-5421
Practice Fax:

1104256197 — LAURIE WADE PHARMD
Practice Location Address:

801 BOULEVARD
KENILWORTH, NJ
07033-1719

Practice Phone: 908-241-5421
Practice Fax:

1639621428 — MICHAEL ABRAMS PHARMD
Practice Location Address:

801 KENILWORTH BLVD
KENILWORTH, NJ
07033-1719

Practice Phone: 908-259-0720
Practice Fax:

1740790278 — ACME MARKETS INC
Practice Location Address:

801 KENILWORTH BLVD
KENILWORTH, NJ
07033-1719

Practice Phone: 908-259-0720
Practice Fax: 908-259-0730

1821091018 — DR. SEAN L. KAUFMAN D.P.M
Practice Location Address:

528 BOULEVARD
KENILWORTH, NJ
07033-1657

Practice Phone: 908-276-6624
Practice Fax: 908-709-0163

1932181732 — MORIBITO RX LLC
Practice Location Address:

21 N 20TH ST
KENILWORTH, NJ
07033-1613

Practice Phone: 908-709-1414
Practice Fax: 908-709-1543

Directions to “GREAT ATLANTIC & PACIFIC TEA COMPANY INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.