Organization
BIG Y FOODS, INC.
Active
Other names
Big Y Pharmacy #58
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL S GOLD (VP/ASSISTANT SECRETARY)
(413) 504-4230
Entity
Organization
Contact information
Practice address
22 SPENCER PLAIN ROAD, OLD SAYBROOK, CT 06475-4000
(860) 395-0515
Mailing address
22 SPENCER PLAIN ROAD, OLD SAYBROOK, CT 06475-4000
(860) 395-0515
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PCY.2295
CT
3336C0003X
Community/Retail Pharmacy
Primary
0002295
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008053346
—
CT
Enumeration date
07/24/2014
Last updated
03/02/2016
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