| NPI | 1457678468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUDHEER GHANTA Member / Sp 860-346-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CT PCY.0002177) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CT PCY0002177) |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2014-07-29 |