Provider Demographics
NPI:1982842530
Name:BIP PHARMACY. LLC
Entity Type:Organization
Organization Name:BIP PHARMACY. LLC
Other - Org Name:MEGA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BIMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:THAKKAR
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:718-294-7899
Mailing Address - Street 1:1560 GRAND CONCOURSE SUITE 100
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-8471
Mailing Address - Country:US
Mailing Address - Phone:718-294-7899
Mailing Address - Fax:718-294-7506
Practice Address - Street 1:1560 GRAND CONCOURSE SUITE 100
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-8471
Practice Address - Country:US
Practice Address - Phone:718-294-7899
Practice Address - Fax:718-294-7506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPENDING333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPENDINGMedicaid
NYPENDINGMedicaid
NYPENDINGMedicare Oscar/Certification