MAIN STREET PHARMACY 3 LLC NPI 1316249352

NPI Information

MAIN STREET PHARMACY 3 LLC is a pharmacy in Bridgeport, CT. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. MAIN STREET PHARMACY 3 LLC NPI is 1316249352. The provider is registered as an organization entity type.

The provider's business location address is:

2117 BOSTON AVE
BRIDGEPORT, CT
ZIP 06610-030
Phone: (203) 212-3800
Fax: (203) 212-3802

The provider's authorized official is Jean K. Jacob .
The authorized official title is Owner and has the following contact phone number 20321238001.

The enumeration date for this NPI number is 11/24/2010 and was last updated on 3/9/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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