=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962337642
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BIG SIX HEALTH INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2026
-----------------------------------------------------
Last Update Date | 06/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6110 QUEENS BLVD
-----------------------------------------------------
City | WOODSIDE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11377-5776
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-606-0422
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6110 QUEENS BLVD
-----------------------------------------------------
City | WOODSIDE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11377-5776
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-606-0422
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | PRATIK PATEL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 404-493-6878
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------