Organization
BIG Y FOODS, INC.
Active
Other names
Big Y Pharmacy #31
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL S GOLD (VP, ASSISTANT SECRETARY)
(413) 504-4492
Entity
Organization
Contact information
Practice address
70 WAUREGAN RD, DANIELSON, CT 06239-3712
(860) 774-7437
(860) 774-0391
Mailing address
2145 ROOSEVELT AVE, SPRINGFIELD, MA 01104-1650
(413) 504-4490
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PCY.1288
CT
3336C0003X
Community/Retail Pharmacy
Primary
PCY.1288
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004268422
—
CT
01
—
PCY.1288
STATE OF CT BOARD OF PHAR
CT
Enumeration date
04/27/2007
Last updated
12/15/2015
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