| NPI | 1508907080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN S AUCOIN President 860-727-1123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CT 1282) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CT 1282) |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: CT 1282) | |
| 3336S0011X Pharmacy, Specialty Pharmacy (Licence: CT 1282) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2020-08-22 |