| NPI | 1952646739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRAVEEN K DHULIPALLA Owner 860-422-8888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CT PCY 002255) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2023-11-21 |