MAIN STREET PHARMACY LLC (NPI# 1609109842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1609109842 |
Entity Type | Organization |
Organization Name | MAIN STREET PHARMACY LLC |
Other Organization Name | MAIN STREET PHARMACY |
Practice Address |
1005 Main St # 1j Bridgeport CT 06604-4221 |
Practice Telephone | 2038709901 |
Practice Fax Number | 2038709903 |
Mailing Telephone | 2038709901 |
Mailing Fax Number | 2038709903 |
Enumeration Date | 2009-09-04 |
Last Update Date | 2010-11-12 |
Authorized Official Name | DR. JEAN JACOB (OWNER) |
Authorized Official Telephone | 9148431881 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
N | 333600000X | Pharmacy | Suppliers | ||
Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PCY0002147 | CT | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NCPDP PROVIDER IDENTIFICATION NUMBER | 0721577 | 01 |
Other Name | Type Code |
---|---|
Main Street Pharmacy | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669652210 | Main Street Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 150 Main Street Pharmacy, Mt Vernon, KY 40456 | 2007-11-13 |
1144374596 | Main Street Pharmacy LLC | Pharmacy | 213 W Main St Ste A, Durham, NC 27701-3258 | 2007-01-23 |
1689700379 | Main Street Pharmacy LLC | Pharmacy | 117 E Main St, East Prairie, MO 63845-1136 | 2007-02-26 |
1982716999 | Main Street Pharmacy LLC | Pharmacy | 601 W Main St, Blanchester, OH 45107-1141 | 2006-08-31 |
Street Address |
1005 MAIN ST # 1J |
City | BRIDGEPORT |
State | CT |
Zip Code | 06604-4221 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780163246 | Jill K Bebey | Pharmacist | 564 A Park Ave, Bridgeport, CT 06604 | 2018-08-07 |
1538663430 | Ryan Attar | Naturopath | 129 Columbia St, Bridgeport, CT 06604 | 2018-03-23 |
1487153375 | Fe Y Esperanza Home Care Services | Home Health | 2032 Main Street, Bridgeport, CT 06604 | 2018-02-06 |
1013423466 | Va.lu Able Home Care LLC | Registered Nurse | 1000 Lafayette Boulvard, Bridgeport, CT 06604 | 2017-12-21 |
1679970172 | Aarti Jawa | Dentist | 594 Pequonnoack Street, Bridgeport, CT 06604 | 2014-11-26 |
1932521473 | Anthony Santostefano | Dentist | 594 Pequonnock Street, Bridgeport, CT 06604 | 2014-01-18 |
1699011536 | Vanessa Frances Doyle | Naturopath | 115 Broad Street, C/o Center of Excellence, Bridgeport, CT 06604 | 2012-12-21 |
1942463302 | Joanna Conte Mcgary | Naturopath | 60 Lafayette Street, Naturopathic Medical Center University of Bridgeport, Bridgeport, CT 06604 | 2008-07-07 |
1346415221 | Jenna Lyn Blasi | Naturopath | 60 Lafayette, University of Bridgeport College of Naturopathic Medici, Bridgeport, CT 06604 | 2008-04-23 |
1275704462 | Watermark 3030 Park LLC | Skilled Nursing Facility | 3030 Park Ave, Bridgeport, CT 06604 | 2008-03-17 |
Find all providers in zip 06604 |
Taxonomy Code | 3336C0003X |
Grouping | Suppliers |
Classification | Pharmacy |
Specialization | Community/Retail Pharmacy |
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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1952909053 | Payne & Pitts, LLC | Pharmacy | 602 Alabama Avenue, Bridgeport, AL 35740-7513 | 2020-10-12 |
1609432459 | Brx LLC | Pharmacy | 319 S Virginia Ave, Bridgeport, WV 26330-1744 | 2019-05-17 |
1871027714 | Unity Pharmacy II LLC | Pharmacy | 679 Fairfield Ave, Bridgeport, CT 06604-3906 | 2017-04-18 |
1063960755 | Workers First Pharmacy Services LLC | Pharmacy | 207 W 4th St Ste B, Bridgeport, PA 19405-1012 | 2016-09-12 |
1265809420 | Ls Health, LLC | Pharmacy | 54 W 4th St, Suite 38, Bridgeport, PA 19405-1009 | 2015-08-24 |
1548673940 | Hope Dispensary of Greater Bridgeport | Pharmacy | 752 E Main St # 170, Bridgeport Dept of Health, Bridgeport, CT 06608-2335 | 2014-06-04 |
1538445101 | Mountaineer Medical Office Building Pharmacy | Pharmacy | 120 Medical Park Dr Ste 102, Bridgeport, WV 26330-9013 | 2011-10-27 |
1093094021 | Right Care Pharmacy Inc | Pharmacy | 2366 Main St, Bridgeport, CT 06606-5339 | 2011-08-09 |
1710287602 | Brookshire Grocery Company | Pharmacy | 1203 Us Highway 380, Bridgeport, TX 76426-2087 | 2010-10-26 |
1699879510 | Connecticut Cvs Pharmacy, L.L.C. | Pharmacy | 3710 Main St, Bridgeport, CT 06606-3613 | 2006-09-12 |
Find all providers in BRIDGEPORT |
City | BRIDGEPORT |
Zip Code | 06604 |
Please comment or provide details below to improve the information on MAIN STREET PHARMACY LLC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.