Organization
BIG Y FOODS, INC.
Active
Other names
Big Y Pharmacy #84
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL S GOLD (VP, ASSISTANT SECRETARY)
14135044492
Entity
Organization
Contact information
Practice address
355 HAWLEY LANE, STRATFORD, CT 06614
(413) 504-4492
Mailing address
2145 ROOSEVELT AVE, SPRINGFIELD, MA 01104-1650
(413) 504-4492
(413) 504-5492
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PCY.2103
CT
3336C0003X
Community/Retail Pharmacy
Primary
PCY.2103
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500000241
—
CT
01
—
PCY.2103
PHARMACY LIC #
CT
Enumeration date
12/24/2007
Last updated
12/15/2015
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