Provider Demographics
NPI:1386683738
Name:BJS WHOLESALE CLUB INC
Entity Type:Organization
Organization Name:BJS WHOLESALE CLUB INC
Other - Org Name:BJS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CELLA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:508-651-5621
Mailing Address - Street 1:4201 WHOLESALE CLUB DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-3408
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4201 WHOLESALE CLUB DR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-3408
Practice Address - Country:US
Practice Address - Phone:410-668-4139
Practice Address - Fax:410-668-7803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP04057333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2127404OtherOTHER ID NUMBER-COMMERCIAL NUMBER
2127404OtherOTHER ID NUMBER-COMMERCIAL NUMBER