Main Street Pharmacy

LBN: Main Street Pharmacy 4 Llc
Main Street Pharmacy is an health care organization with primary practice located at 166 W Broad St , Stamford CT 06902-3661. The organization recently has 5 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Main Street Pharmacy 4 Llc can be contacted via phone (203) 870-9902, or through Jacob, Jean via phone (203) 870-9902.

Contact Information

Primary practice address
166 W Broad St Stamford CT 06902-3661
Phone: (203) 870-9902
Fax: (203) 870-9903
Website:
Map and Directions
Authorized official contact:
Name: Jacob, Jean
Phone: (203) 870-9902

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PCY.0002185 Connecticut
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1689989782
LBN Legal business name Main Street Pharmacy 4 Llc
DBA Doing business as Main Street Pharmacy
Authorized official Jacob, Jean
Entity Organization
Organization subpart 1 No
Enumeration date Aug 12th, 2010
Last updated Aug 23rd, 2011 - about 13 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 1689989782 NPPES
Other 0722062 NCPDP PROVIDER IDENTIFICATION NUMBER

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