Provider Demographics
NPI:1508971540
Name:BJK INC
Entity Type:Organization
Organization Name:BJK INC
Other - Org Name:CHEM RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:LEORA
Authorized Official - Middle Name:
Authorized Official - Last Name:TILOCCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-536-0800
Mailing Address - Street 1:750 PARK PL
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-2110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:790 PARK PL
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-2111
Practice Address - Country:US
Practice Address - Phone:516-536-0800
Practice Address - Fax:516-889-4500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0076663336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3300794OtherOTHER ID NUMBER-COMMERCIAL NUMBER
NY00260559Medicaid
3300794OtherOTHER ID NUMBER
3300794OtherOTHER ID NUMBER