Organization
BIG Y FOODS INC
Active
Other names
Big Y Pharmacy #87
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
1289 FOXON ROAD, ROUTE 80, NORTH BRANFORD, CT 06471
(413) 504-4492
Mailing address
2145 ROOSEVELT AVE, SPRINGFIELD, MA 01104-1650
(413) 504-4492
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PCY.2102
CT
3336C0003X
Community/Retail Pharmacy
Primary
PSY2102
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500000257
—
CT
01
—
PCY2102
PHARMACY LICENSE #
CT
Enumeration date
12/12/2007
Last updated
12/15/2015
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