Main Street Pharmacy

LBN: Main Street Pharmacy Llc
Main Street Pharmacy is an health care organization with primary practice located at 1005 Main St # 1J , Bridgeport CT 06604-4221. 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 Llc can be contacted via phone (203) 870-9901, or through Jacob, Jean via phone (914) 843-1881.

Contact Information

Primary practice address
1005 Main St # 1J Bridgeport CT 06604-4221
Phone: (203) 870-9901
Fax: (203) 870-9903
Website:
Map and Directions
Authorized official contact:
Name: Jacob, Jean
Phone: (914) 843-1881

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PCY0002147 Connecticut
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1609109842
LBN Legal business name Main Street Pharmacy Llc
DBA Doing business as Main Street Pharmacy
Authorized official Jacob, Jean
Entity Organization
Organization subpart 1 No
Enumeration date Sep 4th, 2009
Last updated Nov 12th, 2010 - about 14 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 1609109842 NPPES
Other 0721577 NCPDP PROVIDER IDENTIFICATION NUMBER

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