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PATHMARK PHARMACY
NPI 1689771453
Pharmacy in Brookhaven, PA

Active since September 20, 2006
5005 EDGMONT AVE, BROOKHAVEN, PA 19015(610) 872-4346(610) 872-4574 Get Directions Write a Review

NPPES record last updated: June 30, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pathmark Pharmacy NPPES

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

PATHMARK PHARMACY (NPI 1689771453) is a healthcare organization registered as a pharmacy in Brookhaven, 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

NPI1689771453
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NamePATHMARK STORES INC
Location Address5005 EDGMONT AVEBrookhaven, PA 19015-1202
Mailing Address2 Paragon DrMontvale, NJ 07645-1718 · (201) 573-9700 · Fax (201) 571-8335
Phone(610) 872-4346
Fax(610) 872-4574
Organization SubpartYesParent: The Great Atlantic & Pacific Tea Co Inc
Authorized OfficialSusan D KijowskiPharmacy Specialist · (201) 571-8326
Enumeration DateSeptember 20, 2006
Last NPPES UpdateJune 30, 2008
✔ NPI 1689771453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in PA · PP413030L
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 PP413030L (PA)
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
5005 EDGMONT AVE, Brookhaven, PA 19015
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Other Names 1

Doing Business AsPathmark Pharmacy

Other Identifiers 3

Medicaid0017374600015PA
Medicare NSC0636000015PA
Other3906332Other Id Number-commercial Number

Other Providers at the Same Location NPPES

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

JOHN WILLIAM PITMAN RPH
Pharmacist
5005 EDGMONT AVE
BROOKHAVEN, PA 19015
Delaware County (610) 872-4346

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 1689771453. 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 5005 Edgmont Ave, Brookhaven, PA 19015. The listed phone number is (610) 872-4346.

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 30, 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.