Healthcare Provider Details

I. General information

NPI: 1417131012
Provider Name (Legal Business Name): BJK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 03/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 WALKER WAY
ALBANY NY
12205-4995
US

IV. Provider business mailing address

16 WALKER WAY
ALBANY NY
12205-4995
US

V. Phone/Fax

Practice location:
  • Phone: 518-452-7795
  • Fax: 518-452-4494
Mailing address:
  • Phone: 518-452-7795
  • Fax: 518-452-4494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number028609
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JERRY SILVA
Title or Position: PRESIDENT
Credential:
Phone: 516-536-0800