| NPI | 1134445810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH Y LEE Pharmacy Manager 203-956-0526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CT pcy0002172) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2014-11-18 |