Main Street Pharmacy 3 Llc

LBN: Main Street Pharmacy 3 Llc
Main Street Pharmacy 3 Llc is an health care organization with primary practice located at 2117 Boston Ave , Bridgeport CT 06610-3030. The organization recently has 6 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Parenteral & Enteral Nutrition, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Main Street Pharmacy 3 Llc can be contacted via phone (203) 212-3800, or through Jacob, Jean K. via phone 20321238001.

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 K. PHARM. D
Phone: 20321238001

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Parenteral & Enteral Nutrition 332BP3500X Connecticut
Suppliers / Pharmacy 333600000X PCY2190 Connecticut
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1316249352
LBN Legal business name Main Street Pharmacy 3 Llc
DBA Doing business as
Authorized official Jacob, Jean K. PHARM. D
Entity Organization
Organization subpart 1 No
Enumeration date Nov 24th, 2010
Last updated Mar 9th, 2015 - about 9 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 1316249352 NPPES
Connecticut MEDICAID 008032995

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