Provider Demographics
NPI:1639281199
Name:BJS DRUGS INC
Entity Type:Organization
Organization Name:BJS DRUGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOTTLIEB
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:718-793-1616
Mailing Address - Street 1:6860 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4220
Mailing Address - Country:US
Mailing Address - Phone:718-793-1616
Mailing Address - Fax:718-544-4993
Practice Address - Street 1:6860 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4220
Practice Address - Country:US
Practice Address - Phone:718-793-1616
Practice Address - Fax:718-544-4993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014625183500000X
NY0146243336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3349544OtherNCPDP
NY00262524Medicaid
3349544OtherNCPDP