Healthcare Provider Details

I. General information

NPI: 1265030126
Provider Name (Legal Business Name): BJ'S WHOLESALE CLUB INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2020
Last Update Date: 10/13/2020
Certification Date: 10/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820-825 PELHAM PKWY
PELHAM MANOR NY
10803
US

IV. Provider business mailing address

25 RESEARCH DR
WESTBOROUGH MA
01581-3680
US

V. Phone/Fax

Practice location:
  • Phone: 914-632-1547
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: GINA BISCEGLIA
Title or Position: LEGAL ASSOCIATE
Credential:
Phone: 508-688-2358