| NPI | 1811106461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA FERGUSON Manager Pharmacist 203-732-1490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CT 1711) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT 4819) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2010-06-11 |