Bigelows Pharmacy Inc

Organization Active NPI Community/Retail Pharmacy · Sherburne, NY

NPI 1457429698 · NPPES record last updated Apr 6, 2017

Key facts

NPI
1457429698
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
012930 (NY)
Legal business name
BIGELOWS PHARMACY INC
Practice address
6 N Main St
Sherburne, NY 13460-9545
Phone
(607) 674-9691
Fax
(607) 674-4428
NPI assigned
Dec 4, 2006
Organization subpart
No

Authorized official

Name
John Kwasnik, RPH
Title
Pic
Phone
(607) 674-9691

Other NPIs on the same Medicare enrollment 2

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

Corporate family (same tax ID) 2

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20170804000619 NY Part B Supplier - Other 2769753045 2 other NPIs on this enrollment
Practice locations: New Berlin, NY; Norwich, NY; Sherburne, NY

National Provider Directory

Tax ID family
Bigelows Pharmacy Inc (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 012930 NY Yes

Addresses

Primary practice location

6 N Main St
Sherburne, NY 13460-9545

Mailing address

6 N Main St
PO Box 487
Sherburne, NY 13460-9545
Phone (607) 674-9691

Other identifiers

IdentifierTypeStateIssuer
00550445MedicaidNY
2067340OtherPK

Other names

  • SERVICE PHARMACY SHERBURNE Doing business as

Other providers in Sherburne, NY

All providers in Sherburne, NY · Community/Retail Pharmacy in New York

Sources for this page

Verify at the official NPI Registry.