MEDICARE: LANGS PHARMACY OF WESTON LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	PCY.0002098	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0720981	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1407038904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANGS PHARMACY OF WESTON LLC

Provider Business Mailing Address
First Line	:	190 WESTON RD
Second Line	:
City	:	WESTON
State	:	CT
Zip	:	06883-2126
Country	:	US
Telephone Number	:	203-226-7800
Fax Number	:	203-226-9300

Provider Business Practice Location Address
First Line	:	190 WESTON RD
Second Line	:
City	:	WESTON
State	:	CT
Zip	:	06883-2126
Country	:	US
Telephone Number	:	203-226-7800
Fax Number	:	203-226-9300

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DIANA LEVISON
Credential	:	RPH
Telephone Number	:	203-226-7800

Provider Enumeration Date	:	11/27/2007
Last Update Date	:	09/29/2009

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