NPIMap

Organization Active NPI

Big Y Foods, Inc.

Doing business as Big Y Pharmacy #82

  • Community/Retail Pharmacy
  • Bethel, CT
National Provider Identifier
1376688655
Registry record updated Dec 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PENDING Issued in CT
Legal business name
BIG Y FOODS, INC.
Doing business as
Big Y Pharmacy #82
Practice address
81 Stony Hill Road
Bethel, CT 06801
Phone
(203) 791-9820
Fax
(203) 791-8589
NPI assigned
Feb 21, 2007
Last updated
Dec 15, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Michael S Gold
Title
VP, Assistant Secretary
Phone
(413) 504-4492

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PCY.2078 CT
Community/Retail Pharmacy 3336C0003X PENDING CT Primary

Addresses

Primary practice location

81 Stony Hill Road
Bethel, CT 06801

Mailing address

2145 Roosevelt Ave
Springfield, MA 01104-1650
Phone (141) 350-4449

Other identifiers 1

IdentifierTypeStateIssuer
004266632MedicaidCT

Other names 1

  • Big Y Pharmacy #82 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20091009000236 CT Part B Supplier - Mass Immunization (Roster Biller Only) 9335285089 19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Torrington, CT; Tolland, CT; Stratford, CT; Stafford Springs, CT; Old Saybrook, CT; Norwich, CT; Mansfield Center, CT; North Branford, CT…
O20100930005027 CT DME Supplier - PharmacyDME Supplier - Grocery Store 9335285089 Practice locations: Bethel, CT

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Big Y Pharmacy #8281 Stony Hill Rd, Bethel, CT 06801(203) 791-9820 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Does not accept assignmentParticipating since Dec 11, 2015

National Provider Directory

National Provider Directory
Tax ID family
Big Y Foods Inc36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Locations

81 Stony Hill Rd
Bethel, CT 06801
Phone (203) 791-9820

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450137600000",
    "number": "1376688655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 ROOSEVELT AVE",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011041650",
            "telephone_number": "141-350-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 STONY HILL ROAD",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "06801",
            "telephone_number": "203-791-9820",
            "fax_number": "203-791-8589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG Y FOODS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2015-12-15",
        "status": "A",
        "authorized_official_last_name": "GOLD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VP, ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "14135044492",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "PCY.2078",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004266632",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Big Y Pharmacy #82",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bethel, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.