| NPI | 1174070452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL K GRANT Pharmacist 860-869-7251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: CT 00011965) |
| Enumeration Date | 2016-09-05 |
| Last Update Date | 2016-09-05 |