Bonneville Pharmacy

LBN: Bonneville Rx Llc
Bonneville Pharmacy is an health care organization with primary practice located at 77 Westcott Rd , Danielson CT 06239-2929. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Bonneville Rx Llc can be contacted via phone (860) 774-9362, or through Annamaneni, Ravinder via phone (860) 774-9362.

Contact Information

Primary practice address
77 Westcott Rd Danielson CT 06239-2929
Phone: (860) 774-9362
Fax: (860) 779-2647
Website:
Map and Directions
Authorized official contact:
Name: Annamaneni, Ravinder
Phone: (860) 774-9362

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X PCY0000159 Connecticut

Profile Details

NPI number 1164587580
LBN Legal business name Bonneville Rx Llc
DBA Doing business as Bonneville Pharmacy
Authorized official Annamaneni, Ravinder
Entity Organization
Organization subpart 1 No
Enumeration date Dec 26th, 2006
Last updated Sep 9th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164587580 NPPES
Other 2138266 PK

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