Provider Demographics
NPI:1669718078
Name:BIG Y FOODS, INC.
Entity type:Organization
Organization Name:BIG Y FOODS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:SEMANIE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:413-504-4490
Mailing Address - Street 1:60 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-3225
Mailing Address - Country:US
Mailing Address - Phone:413-504-6410
Mailing Address - Fax:413-504-6414
Practice Address - Street 1:60 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3225
Practice Address - Country:US
Practice Address - Phone:413-504-6410
Practice Address - Fax:413-504-6414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADS89837332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies