Provider Demographics
NPI:1629350251
Name:SUPER FRESH FOOD MARKETS, INC.
Entity Type:Organization
Organization Name:SUPER FRESH FOOD MARKETS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, REGULATORY COMPLIANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:KIJOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-571-8326
Mailing Address - Street 1:2 PARAGON DR
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1718
Mailing Address - Country:US
Mailing Address - Phone:201-571-8326
Mailing Address - Fax:201-571-8335
Practice Address - Street 1:2 PARAGON DR
Practice Address - Street 2:
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-1718
Practice Address - Country:US
Practice Address - Phone:201-571-8326
Practice Address - Fax:201-571-8335
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE GREAT ATLANTIC & PACIFIC TEA COMPANY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy