Provider Demographics
NPI:1790734655
Name:B&M FAMILY PHARMACY CORP
Entity Type:Organization
Organization Name:B&M FAMILY PHARMACY CORP
Other - Org Name:B&M FAMILY PHARMACY CORP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLTON
Authorized Official - Middle Name:
Authorized Official - Last Name:BEHARRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-859-0007
Mailing Address - Street 1:1001 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-5006
Mailing Address - Country:US
Mailing Address - Phone:718-859-0007
Mailing Address - Fax:718-724-2609
Practice Address - Street 1:1001 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-5006
Practice Address - Country:US
Practice Address - Phone:718-859-0007
Practice Address - Fax:718-724-2609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
NY0267623336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02586116Medicaid
2063003OtherPK
NY02586116Medicaid