Healthcare Provider Details

I. General information

NPI: 1639281199
Provider Name (Legal Business Name): BJS DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 01/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6860 AUSTIN ST
FOREST HILLS NY
11375-4220
US

IV. Provider business mailing address

6860 AUSTIN ST
FOREST HILLS NY
11375-4220
US

V. Phone/Fax

Practice location:
  • Phone: 718-793-1616
  • Fax: 718-544-4993
Mailing address:
  • Phone: 718-793-1616
  • Fax: 718-544-4993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number014625
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number014624
License Number StateNY

VIII. Authorized Official

Name: MR. STAN GOTTLIEB
Title or Position: PRESIDENT
Credential: RPH
Phone: 718-793-1616