| NPI | 1508855842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD KENNETH BATES Owner 203-426-4505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CT 0200) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CT 0200) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2020-08-22 |