| NPI | 1598777153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES F ETUK President 860-749-3824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: CT 2068) |
| Additional Taxonomies | 183500000X Pharmacist |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CT 2068) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CT 2068) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2012-05-03 |