| NPI | 1780182766 |
|---|---|
| Doing Business As | MAIN STREET PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JEAN JACOB Member 203-212-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: CT PCY2190) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2018-01-25 |
| Last Update Date | 2018-01-25 |