MEDICARE: PATHMARK STORES 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	RS28003664	NJ
2	3336C0003X	Community/Retail Pharmacy
3	333600000X	Pharmacy	RS003664	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3127025	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184721946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATHMARK STORES INC

Provider Business Mailing Address
First Line	:	2 PARAGON DR
Second Line	:
City	:	MONTVALE
State	:	NJ
Zip	:	07645-1718
Country	:	US
Telephone Number	:	201-573-9700
Fax Number	:

Provider Business Practice Location Address
First Line	:	242 LINCOLN BLVD.
Second Line	:
City	:	MIDDLESEX
State	:	NJ
Zip	:	08846-2305
Country	:	US
Telephone Number	:	732-356-0440
Fax Number	:	732-356-5349

Authorized Official
Title or Position	:	PHARMACY SPECIALIST
Name	:	SUSAN D KIJOWSKI
Credential	:
Telephone Number	:	201-571-8326

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	01/27/2009

Similar Medicare Providers

1669472296 — GENERAL HEALTH SERVICES
Practice Location Address:

282 LINCOLN BLVD
MIDDLESEX, NJ
08846-2305

Practice Phone: 732-356-3736
Practice Fax: 732-356-0945

1649104787 — EDMOND GASHI
Practice Location Address:

220 LINCOLN BLVD
MIDDLESEX, NJ
08846-1738

Practice Phone: 848-202-1439
Practice Fax:

1801888169 — DRUG FAIR GROUP, INC.
Practice Location Address:

738 UNION AVE
MIDDLESEX, NJ
08846-1941

Practice Phone: 732-356-0877
Practice Fax: 732-356-4117

1477549657 — CORNELL HEALTHCARE CORP
Practice Location Address:

368 LINCOLN BLVD
MIDDLESEX, NJ
08846-2372

Practice Phone: 732-247-6666
Practice Fax: 732-247-6664

1700875218 — DR. CHARANPREET SINGH DMD
Practice Location Address:

530 UNION AVE
MIDDLESEX, NJ
08846-1934

Practice Phone: 732-356-1606
Practice Fax: 732-356-1501

1831171958 — SLEEP ON CALL, INC.
Practice Location Address:

1316 BOUND BROOK RD
MIDDLESEX, NJ
08846-1439

Practice Phone: 732-469-6862
Practice Fax: 732-469-3013

Directions to “PATHMARK STORES 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.