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	3336C0003X	Community/Retail Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies	05389	NJ
3	333600000X	Pharmacy	05389	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3138434	OTHER	OTHER ID NUMBER-COMMERCIAL NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952326514
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	:	1730 US HIGHWAY 46
Second Line	:
City	:	WEST PATERSON
State	:	NJ
Zip	:	07424-1716
Country	:	US
Telephone Number	:	973-812-3434
Fax Number	:	973-812-3433

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

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1669641924 — MR. EUGENE RAYMOND TOMPKINS RPH
Practice Location Address:

1730 US HIGHWAY 46
WEST PATERSON, NJ
07424-1716

Practice Phone: 973-812-3434
Practice Fax: 973-812-9433

1063527968 — DR. ROY ROBERT HENDERSON DPM
Practice Location Address:

60 WEST UNION AVE
BOUND BROOK, NJ
08805-1716

Practice Phone: 732-469-3668
Practice Fax: 732-469-3650

1770669962 — COUNTY OF WARREN
Practice Location Address:

544 WEST RIDGEWAY STREET
WARRENTON, NC
27589-1716

Practice Phone: 252-257-1185
Practice Fax: 252-257-2897

1215015615 — QUALITY RESPIRATORY CARE INC
Practice Location Address:

1239 W HIGHWAY 49
WEST HELENA, AR
72390-1716

Practice Phone: 870-572-1000
Practice Fax: 870-572-1026

1124182514 — MRS. SHARON L CAMPBELL ARNP
Practice Location Address:

1188 RALPH DAVID ABERNATHY BLVD WEST END
ATLANTA, GA
30310-1716

Practice Phone: 404-755-0570
Practice Fax: 404-755-0520

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.