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NPI Code Detail

MEDICARE: SIRA PHARMACY LLC

MEDICARE: SIRA PHARMACY 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
13336C0003XCommunity/Retail Pharmacy0001772CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12134351OTHERPK

General Provider Information

NPI Number : 1659642718
Entity Type Code : Organization
Provider Name (Legal Business Name) : SIRA PHARMACY LLC
Provider Business Mailing Address
First Line : 296 BEDFORD ST
Second Line :
City : STAMFORD
State : CT
Zip : 06901-1720
Country : US
Telephone Number : 203-327-4479
Fax Number : 203-975-0427
Provider Business Practice Location Address
First Line : 296 BEDFORD ST
Second Line :
City : STAMFORD
State : CT
Zip : 06901-1720
Country : US
Telephone Number : 203-327-4479
Fax Number : 203-975-0427
Authorized Official
Title or Position : PRESIDENT
Name : MAYUR PATEL
Credential :
Telephone Number : 203-327-4479
Provider Enumeration Date : 01/21/2012
Last Update Date : 07/05/2016

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Directions to “SIRA PHARMACY LLC ” Practice Location

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