# BIG MART PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Big Mart Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073667432
- **Authorized official:** MR. PETER PERVEZ (PRESIDENT)
- **Authorized official phone:** (718) 092-3116

## Contact information

- **Practice address:** 2740 3RD AVENUE, BRONX, NY 10455
- **Practice address phone:** (718) 292-3116
- **Practice address fax:** (718) 292-3142
- **Mailing address:** 2740 3RD AVENUE, BRONX, NY 10455
- **Mailing address phone:** (718) 292-3116
- **Mailing address fax:** (718) 292-3142

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 3112 | NY | Yes |

## Other

- **Enumeration date:** 01/23/2007
- **Last updated:** 09/11/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 02785817 | — | NY |