Provider Demographics
NPI:1568401917
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 1:2435 E WEST CONNECTOR
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-8196
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2435 E WEST CONNECTOR
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-8196
Practice Address - Country:US
Practice Address - Phone:770-439-3863
Practice Address - Fax:770-439-3947
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
GAPHRE008751333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1151202OtherOTHER ID NUMBER-COMMERCIAL NUMBER
5083210001Medicare ID - Type Unspecified