| NPI | 1164624235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELO DEFAZIO President CEO 860-570-0543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CT 0347) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: CT 0347) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CT 0347) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2020-08-22 |