<Unavail>

LBN: Main Street Pharmacy 3 Llc
<Unavail> is an health care organization with primary practice located at 2117 Boston Ave , Bridgeport CT 06610-3030. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Main Street Pharmacy 3 Llc can be contacted via phone (203) 212-3800, or through Jacob, Jean via phone (203) 212-3800.

Contact Information

Primary practice address
2117 Boston Ave Bridgeport CT 06610-3030
Phone: (203) 212-3800
Fax: (203) 212-3802
Website:
Map and Directions
Authorized official contact:
Name: Jacob, Jean
Phone: (203) 212-3800

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Long Term Care Pharmacy 3336L0003X PCY2190 Connecticut

Profile Details

NPI number 1780182766
LBN Legal business name Main Street Pharmacy 3 Llc
DBA Doing business as <Unavail>
Authorized official Jacob, Jean
Entity Organization
Organization subpart 1 No
Enumeration date Jan 25th, 2018
Last updated Jan 25th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780182766 NPPES
Other 2170877 PK
MEDICAID 008032995 PK

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