| NPI | 1154569481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANDRA S VIPPARLA Pharmacy Manager 203-785-9001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CT PCY2133) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy (Licence: CT PCY2133) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CT PCY2133) | |
| Enumeration Date | 2009-01-23 |
| Last Update Date | 2023-02-08 |