MEDICARE: BBMJ INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	024893	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2063885	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962417584
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BBMJ INC

Provider Business Mailing Address
First Line	:	PO BOX 1050
Second Line	:
City	:	SAG HARBOR
State	:	NY
Zip	:	11963-0033
Country	:	US
Telephone Number	:	631-725-0074
Fax Number	:	631-725-8672

Provider Business Practice Location Address
First Line	:	120 MAIN ST
Second Line	:
City	:	SAG HARBOR
State	:	NY
Zip	:	11963-3007
Country	:	US
Telephone Number	:	631-725-0074
Fax Number	:	631-725-8672

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BARRY MARCUS
Credential	:
Telephone Number	:	621-725-0074

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	12/10/2013

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Directions to “BBMJ INC ” Practice Location

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