Connecticut Pharmacy

LBN: Connecticut Pharmacy Llc
Connecticut Pharmacy is an health care organization with primary practice located at 664 Main Ave Unit B101-102 , Norwalk CT 06851-1162. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Compounding Pharmacy, Suppliers / Long Term Care Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Connecticut Pharmacy Llc can be contacted via phone (203) 939-1790, or through Wolak, Scott via phone (203) 518-1146.

Contact Information

Primary practice address
664 Main Ave Unit B101-102 Norwalk CT 06851-1162
Phone: (203) 939-1790
Fax: (203) 939-1789
Website:
Map and Directions
Authorized official contact:
Name: Wolak, Scott RPH
Phone: (203) 518-1146

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Long Term Care Pharmacy 3336L0003X 0002254 Connecticut
Suppliers / Specialty Pharmacy 3336S0011X

Profile Details

NPI number 1063757631
LBN Legal business name Connecticut Pharmacy Llc
DBA Doing business as Connecticut Pharmacy
Authorized official Wolak, Scott RPH
Entity Organization
Organization subpart 1 No
Enumeration date Dec 7th, 2012
Last updated Oct 29th, 2018 - about 6 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 1063757631 NPPES
Other 0722973 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID 008043469 NCPDP PROVIDER IDENTIFICATION NUMBER

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