Provider Demographics
NPI:1043719131
Name:B&E PHARMACEUTICALS, INC.
Entity Type:Organization
Organization Name:B&E PHARMACEUTICALS, INC.
Other - Org Name:B&E PHARMACEUTICALS, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEMBER REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:CADDICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-877-2536
Mailing Address - Street 1:63 52 WOODHAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2831
Mailing Address - Country:US
Mailing Address - Phone:718-651-1000
Mailing Address - Fax:718-476-3776
Practice Address - Street 1:63 52 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2831
Practice Address - Country:US
Practice Address - Phone:718-651-1000
Practice Address - Fax:718-476-3776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0202773336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2175452OtherPK
NY1148416Medicaid