MEDICARE: BAKER PHARMACY LTD

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
2	333600000X	Pharmacy	0085	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0702844	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1982684890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAKER PHARMACY LTD

Provider Business Mailing Address
First Line	:	140 GREENWOOD AVE
Second Line	:
City	:	BETHEL
State	:	CT
Zip	:	06801-2530
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 GREENWOOD AVE
Second Line	:
City	:	BETHEL
State	:	CT
Zip	:	06801-2530
Country	:	US
Telephone Number	:	203-744-0945
Fax Number	:	203-790-4169

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DANIEL BOULANGER
Credential	:
Telephone Number	:	203-244-0945

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	09/11/2025

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Directions to “BAKER PHARMACY LTD ” Practice Location

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