Bristol Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BRISTOL PHARMACY LLC

Doing business as

Bristol Pharmacy

Practice address

194 Main St
Bristol, CT 06010-6308

Phone

(860) 845-5492

Fax

(860) 845-5634

NPI assigned

Sep 30, 2021

Last updated

Oct 4, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Moyad Elmarjeh

Title

Authorized Official

Phone

(860) 845-5492

Specialties & licenses 1

Addresses

Other names 1

• Bristol Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1497427231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 MAIN ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060106308",
            "telephone_number": "860-845-5492",
            "fax_number": "860-845-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 MAIN ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060106308",
            "telephone_number": "860-845-5492",
            "fax_number": "860-845-5634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-30",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "ELMARJEH",
        "authorized_official_first_name": "MOYAD",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "860-845-5492"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bristol Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bristol Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bristol Hospital Multi-Specialty Group, Inc.
• Bristol Hospital Multi-Specialty Group, Inc.
• Bristol Oral Surgery & Implant Center
• Bristol Orthopaedics LLC
• Bristol Pathology Consultants, P.C.
• Bristol Physical Therapy, LLC
• Bristol Plaza Family Dental
• Bristol Primary Care LLC
• Bristol Radiation Oncology Center
• Bristol SNF Operations, LLC

• Community/Retail Pharmacy in Bristol, CT
• Providers in Bristol, CT by specialty
• Community/Retail Pharmacy in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.