| NPI | 1669927703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL GLEASON Pharmacy Manager 860-727-1123 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: CT 1282) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2016-08-18 |