PATHMARK PHARMACY
NPI 1205933074
Pharmacy in Philadelphia, PA

Q: What is Pathmark Stores Inc's NPI number?

The NPI number for Pathmark Stores Inc is 1205933074. It was assigned to this organization in the NPPES registry on September 20, 2006. The provider is doing business as Pathmark Pharmacy.

Q: What is Pathmark Stores Inc's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Active since September 20, 2006

3021 GRAYS FERRY AVE, PHILADELPHIA, PA 19146(215) 551-7284(215) 468-5218 Get Directions Write a Review

NPPES record last updated: June 27, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Pathmark Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PATHMARK PHARMACY (NPI 1205933074) is a healthcare organization registered as a pharmacy in Philadelphia, Pennsylvania and active in the NPI registry since September 2006. The organization lists Susan D Kijowski, Pharmacy Specialist, as its authorized official.

NPPES Registry Identity

NPI1205933074

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NamePATHMARK STORES INC

Location Address3021 GRAYS FERRY AVEPhiladelphia, PA 19146-2709

Mailing Address2 Paragon DrMontvale, NJ 07645-1718 · (201) 573-9700 · Fax (201) 571-8335

Phone(215) 551-7284

Fax(215) 468-5218

Organization SubpartYesParent: The Great Atlantic & Pacific Tea Co Inc

Authorized OfficialSusan D KijowskiPharmacy Specialist · (201) 571-8326

Enumeration DateSeptember 20, 2006

Last NPPES UpdateJune 27, 2008

✔ NPI 1205933074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers

Taxonomy Code333600000X

License✔ Licensed in PA · PP414226L

Definition

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.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X · License PP414226L (PA)

Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X

3021 GRAYS FERRY AVE, Philadelphia, PA 19146

Open in Google Maps ↗

Other Names 1

Doing Business AsPathmark Pharmacy

Other Identifiers 3

Medicaid0017374600010PA

Other3958571Other Id Number-commercial Number

Medicare NSC0636000016PA

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. LINDA DENISE WADDELL RPH

Pharmacist

3021 GRAYS FERRY AVE
PHILADELPHIA, PA 19146

Philadelphia County (215) 551-7284

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pathmark Stores Inc's NPI number?

The NPI number for Pathmark Stores Inc is 1205933074. It was assigned to this organization in the NPPES registry on September 20, 2006. The provider is doing business as Pathmark Pharmacy.

Where is Pathmark Stores Inc located?

Pathmark Stores Inc is located at 3021 Grays Ferry Ave, Philadelphia, PA 19146. The listed phone number is (215) 551-7284.

What is Pathmark Stores Inc's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

When was this NPI record last updated?

The NPPES record for Pathmark Stores Inc was last updated on June 27, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.