| NPI | 1659915643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES M HARRIS Regional Director Of Reimbursement 860-714-4396 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2022-06-01 |