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PATHMARK PHARMACY
NPI 1558461590
Pharmacy in Staten Island, NY

Active since September 22, 2006
100 GREAVES LANE, STATEN ISLAND, NY 10308(718) 227-0667(718) 227-4551 Get Directions Write a Review

NPPES record last updated: March 13, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Pathmark Pharmacy NPPES

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

PATHMARK PHARMACY (NPI 1558461590) is a healthcare organization registered as a pharmacy in Staten Island, New York and active in the NPI registry since September 2006. The organization lists Susan D Kijowski, Pharmacy Specialist, as its authorized official.

NPPES Registry Identity

NPI1558461590
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NamePATHMARK STORES INC
Location Address100 GREAVES LANEStaten Island, NY 10308-2171
Mailing Address2 Paragon DrMontvale, NJ 07645-1718 · (201) 573-9700 · Fax (201) 571-8335
Phone(718) 227-0667
Fax(718) 227-4551
Organization SubpartYesParent: The Great Atlantic & Pacific Tea Company, Inc.
Authorized OfficialSusan D KijowskiPharmacy Specialist · (201) 571-8326
Enumeration DateSeptember 22, 2006
Last NPPES UpdateMarch 13, 2009
✔ NPI 1558461590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in NY · 019261
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 019261 (NY)
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
100 GREAVES LANE, Staten Island, NY 10308
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Other Names 1

Doing Business AsPathmark Pharmacy

Other Identifiers 3

Other3388469Other Id Number-commercial Number
Medicare NSC0636000022NY
Medicaid00986190NY

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 1558461590. It was assigned to this organization in the NPPES registry on September 22, 2006. The provider is doing business as Pathmark Pharmacy.

Where is Pathmark Stores Inc located?

Pathmark Stores Inc is located at 100 Greaves Lane, Staten Island, NY 10308. The listed phone number is (718) 227-0667.

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 March 13, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.