Main Street Pharmacy 3 Llc
Pharmacy
2117 Boston Ave, Bridgeport
Connecticut, 06610-3030
203-212-3800 203-212-3802
Main Street Pharmacy 3 Llc is a Pharmacy in Bridgeport, Connecticut. It is located at 2117 Boston Ave, Bridgeport and it's customer support contact number is 203-212-3800. The authorized person of Main Street Pharmacy 3 Llc is Dr. Jean K. Jacob, PHARM. D who is Owner of the pharmacy and his contact number is 203-212-38001. Active license number of Main Street Pharmacy 3 Llc is PCY2190 for Pharmacy in Connecticut. Main Street Pharmacy 3 Llc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Main Street Pharmacy 3 Llc is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
Pharmacy Details:
Main Street Pharmacy 3 Llc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Main Street Pharmacy 3 Llc |
| Type: | Pharmacy |
| Location: | 2117 Boston Ave, Bridgeport,
Connecticut, 06610-3030 |
| Phone: | 203-212-3800 |
| Fax: | 203-212-3802 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Jean K. Jacob |
| Credentials: | PHARM. D |
| Position: | Owner |
| Contact Number: | 203-212-38001 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1316249352 |
| NPI Enumeration Date: | 24 Nov, 2010 |
| NPI Last Update On: | 09 Mar, 2015 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Main Street Pharmacy 3 Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Pharmacy | PCY2190 | Connecticut | Primary | |
| Durable Medical Equipment & Medical Supplies | | | Secondary | |
| Community/Retail Pharmacy | | | Secondary | |
| Compounding Pharmacy | | | Secondary | |
| Specialty Pharmacy | | | Secondary | |
| Parenteral & Enteral Nutrition | | Connecticut | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 008032995 | Medicaid | Connecticut | |
Medicare Enrollment:
Main Street Pharmacy 3 Llc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 0547585184 | O20150203000012 | Main Street Pharmacy 3 Llc | PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY) |
| 0547585184 | O20150227000867 | Main Street Pharmacy 3 Llc | DME SUPPLIER - PHARMACY |
Products Available:
Main Street Pharmacy 3 Llc has following products available for sale under medicare.
| Products: |
|---|
| • Blood Glucose Monitors & Supplies: Non-mail Order | • Canes & Crutches |
| • Commodes, Urinals, & Bedpans | • Enteral Nutrients |
| • Heat & Cold Applications | • Nebulizer Equipment & Supplies |
| • Orthoses: Off-the-shelf | • Ostomy Supplies |
| • Seat Lift Mechanisms | • Surgical Dressings |
| • Tracheostomy Supplies | • Urological Supplies |
| • Walkers | • Wheelchair Seating/cushions |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 2117 Boston Ave,
Bridgeport, Connecticut |
| Zip: | 06610-3030 |
| Phone Number: | 203-212-3800 |
| Fax Number: | 203-212-3802 |
Patients can reach Main Street Pharmacy 3 Llc at
2117 Boston Ave, Bridgeport, Connecticut or can
call on customer care at 203-212-3800.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.