MAIN STREET PHARMACY
NPI 1780182766
Pharmacy - Long Term Care Pharmacy in Bridgeport, CT
NPI Status: Active since January 25, 2018
Contact Information
2117 BOSTON AVE
BRIDGEPORT, CT
ZIP 06610
Phone: (203) 212-3800
Fax: (203) 212-3802
- Organization
- Pharmacy
- Long Term Care Pharmacy
- Accepts Insurance
- CLIA Number: 07D2119191
- CLIA Cert. Type: Pharmacy
- CLIA Exp. Date: 09-20-2026
About MAIN STREET PHARMACY
This page provides the complete NPI Profile along with additional information for Main Street Pharmacy, a provider established in Bridgeport, Connecticut operating as a Pharmacy, focusing in long term care pharmacy . The healthcare provider is registered in the NPI registry with number 1780182766 assigned on January 2018. The practitioner's primary taxonomy code is 3336L0003X with license number PCY2190 (CT). The provider is registered as an organization and their NPI record was last updated 8 years ago. The provider's is doing business as Main Street Pharmacy. The authorized official of this NPI record is Jean Jacob (Member)
- NPI
- 1780182766
- Provider Legal Name
- MAIN STREET PHARMACY 3 LLC
- Other Organization Name
- MAIN STREET PHARMACY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 2117 BOSTON AVE BRIDGEPORT, CT 06610
- Location Phone
- (203) 212-3800
- Location Fax
- (203) 212-3802
- Mailing Address
- 2117 BOSTON AVE BRIDGEPORT, CT 06610
- Mailing Phone
- (203) 212-3800
- Mailing Fax
- (203) 212-3802
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-25-2018
- Last Update Date
- 01-25-2018
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy Long Term Care Pharmacy
- Taxonomy Code
- 3336L0003X
- Type
- Suppliers
- License No.
- PCY2190
- License State
- CT
- Taxonomy Description
- A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 333600000X | Suppliers | Pharmacy |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- SummaCare Bronze 10600 with 3 Free PCP Visits - HMO
- SummaCare Bronze 10600 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Bronze 8000 - HMO
- SummaCare Bronze 8000 with Adult Vision Exam - HMO
- SummaCare Gold 1000 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Gold 2000 with 3 Free PCP Visits - HMO
- SummaCare Gold 2000 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Silver 3500 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Silver 5000 1000 Rx with 3 Free PCP Visits - HMO
- SummaCare Silver 6000 with 3 Free PCP Visits + Adult Vision - HMO
- SummaCare Silver 7000 with 3 Free PCP Visits - HMO
- SummaCare Standard Bronze - HMO
- SummaCare Standard Bronze with Adult Vision - HMO
- SummaCare Standard Gold - HMO
- SummaCare Standard Gold with Adult Vision - HMO
- SummaCare Standard Silver - HMO
- SummaCare Standard Silver with Adult Vision - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 008032995 | MEDICAID (05) | CT | |
| 2170877 | OTHER (01) | PK |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 07D2119191
- Facility Type
- Pharmacy
- Certificate Effective Date
- September 21, 2024
- Certificate Expiration Date
- September 20, 2026
- Laboratory Director
- JEAN K. JACOB
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Main Street Pharmacy to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for MAIN STREET PHARMACY
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1780182766, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 64 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 6 providers are registered at the same or a nearby location.
BRIDGEPORT, CT 06610
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1780182766, enumerated as an "organization" on January 25, 2018.
The provider is located at 2117 BOSTON AVE BRIDGEPORT, CT 06610 and the phone number is (203) 212-3800.
Pharmacy with taxonomy code 3336L0003X and a focus in Long Term Care Pharmacy.
The provider might be accepting Accepts: SummaCare, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
