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General NPI Number Information
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NPI Number | 1659319663
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Entity Type | Organization
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Legal Business Name | BJS WHOLESALE CLUB INC
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17250 NW 57TH AVE
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City | HIALEAH
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State | FL
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Zip | 33015-5100
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Country | US
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Telephone | 305-557-2440
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Fax | 305-557-8446
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Provider Business Mailing Address
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Address Line | 17250 NW 57TH AVE
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City | HIALEAH
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State | FL
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Zip | 33015-5100
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSISTANT VICE PRESIDENT
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Name | CHRIS CELLA
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Credential | RPH
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Telephone | 508-651-5621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | PH21775
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License Number State | FL
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