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General NPI Number Information
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NPI Number | 1982887030
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Entity Type | Organization
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Legal Business Name | BIG Y FOODS INC
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 12/15/2015
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Provider Practice Location Address
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Address Line | 1289 FOXON ROAD ROUTE 80
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City | NORTH BRANFORD
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State | CT
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Zip | 06471
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Country | US
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Telephone | 413-504-4492
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Fax |
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Provider Business Mailing Address
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Address Line | 2145 ROOSEVELT AVE
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City | SPRINGFIELD
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State | MA
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Zip | 01104-1650
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Country | US
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Telephone | 413-504-4492
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Fax |
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Authorized Official
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Title or Position | VP, ASSISTANT SECRETARY
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Name | MR. MICHAEL S GOLD
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Credential |
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Telephone | 413-504-4492
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PCY.2102
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PSY2102
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License Number State | CT
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