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NPI Code Detail

MEDICARE: BIG Y FOODS INC

MEDICARE: BIG Y FOODS 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
1333600000XPharmacyPCY1788CT
2332B00000XDurable Medical Equipment & Medical Supplies
33336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20719091OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1043309677
Entity Type Code : Organization
Provider Name (Legal Business Name) : BIG Y FOODS INC
Provider Business Mailing Address
First Line : 67 PROSPECT HILL RD
Second Line :
City : EAST WINDSOR
State : CT
Zip : 06088-3605
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 67 PROSPECT HILL RD
Second Line :
City : EAST WINDSOR
State : CT
Zip : 06088-3605
Country : US
Telephone Number : 860-623-1407
Fax Number : 860-623-1640
Authorized Official
Title or Position : PHARMACY OPERATIONS MANAGER
Name : GEORGE PAPPAS
Credential :
Telephone Number : 413-504-4492
Provider Enumeration Date : 10/12/2006
Last Update Date : 07/16/2012

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Directions to “BIG Y FOODS INC ” Practice Location

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