| NPI | 1003036435 |
|---|---|
| Doing Business As | PEQUOT HEALTH CARE |
| Entity Type | Organization |
| Authorized Contact | EDWARD MOLDENHAUER Director Of Pharmacy Operation 860-396-2058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy (Licence: CT ISH285960015) |
| Additional Taxonomies | 3336M0002X Pharmacy, Mail Order Pharmacy |
| 3336M0003X Pharmacy, Managed Care Organization Pharmacy | |
| 333600000X Pharmacy | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2011-04-01 |