Provider Demographics
NPI:1497427231
Name:BRISTOL PHARMACY LLC
Entity Type:Organization
Organization Name:BRISTOL PHARMACY LLC
Other - Org Name:BRISTOL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RANA
Authorized Official - Middle Name:WAQAR
Authorized Official - Last Name:JOYIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-845-5492
Mailing Address - Street 1:194 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-6308
Mailing Address - Country:US
Mailing Address - Phone:860-845-5492
Mailing Address - Fax:860-845-5634
Practice Address - Street 1:194 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-6308
Practice Address - Country:US
Practice Address - Phone:860-261-7945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-30
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy