NPIMap

Organization Active NPI

Big Y Foods, Inc.

Doing business as Big Y Pharmacy #56

  • Community/Retail Pharmacy
  • New Milford, CT
National Provider Identifier
1821329335
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PCY.0001881 Issued in CT
Legal business name
BIG Y FOODS, INC.
Doing business as
Big Y Pharmacy #56
Practice address
1 Kent Rd
New Milford, CT 06776-3405
Phone
(860) 354-5554
NPI assigned
Jan 22, 2010
Last updated
Dec 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

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

Authorized official

Name
George Pappas, RPHNPI 1689676447
Title
Manager of Pharmacy Operations
Phone
(413) 504-4492

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PCY.2160 CT
Community/Retail Pharmacy 3336C0003X PCY.0001881 CT Primary

Addresses

Primary practice location

1 Kent Rd
New Milford, CT 06776-3405

Mailing address

2145 Roosevelt Ave
Attn: Pharmacy Dept.
Springfield, MA 01104-1650
Phone (860) 354-5554

Other identifiers 2

IdentifierTypeStateIssuer
PCY.2160OtherCTSTATE PHARMACY LICENSE
008014079MedicaidCT

Other names 1

  • Big Y Pharmacy #56 Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930042517 CT DME Supplier - PharmacyDME Supplier - Grocery Store 9335285089 Practice locations: New Milford, CT
O20160126002113 CT Part B Supplier - Mass Immunization (Roster Biller Only) 9335285089 Practice locations: New Milford, CT

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

1 Kent Rd
New Milford, CT 06776
Phone (860) 354-5554

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450828800000",
    "number": "1821329335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 ROOSEVELT AVE",
            "address_2": "ATTN: PHARMACY DEPT.",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011041650",
            "telephone_number": "860-354-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KENT RD",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067763405",
            "telephone_number": "860-354-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG Y FOODS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-22",
        "last_updated": "2015-12-23",
        "status": "A",
        "authorized_official_last_name": "PAPPAS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "MANAGER OF PHARMACY OPERATIONS",
        "authorized_official_telephone_number": "413-504-4492",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "PCY.2160",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "PCY.0001881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY LICENSE",
            "identifier": "PCY.2160",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008014079",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Big Y Pharmacy #56",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Milford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; 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.