Healthcare Provider Details

I. General information

NPI: 1245245893
Provider Name (Legal Business Name): BEJAY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 11/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BOULEVARD
HASBROUCK HEIGHTS NJ
07604-1518
US

IV. Provider business mailing address

450 BOULEVARD
HASBROUCK HEIGHTS NJ
07604-1518
US

V. Phone/Fax

Practice location:
  • Phone: 201-288-0404
  • Fax: 201-288-8125
Mailing address:
  • Phone: 201-288-0404
  • Fax: 201-288-8125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00657200
License Number StateNJ

VIII. Authorized Official

Name: SAM PAPASAVAS
Title or Position: OWNER/RPH
Credential:
Phone: 201-288-0404