Healthcare Provider Details

I. General information

NPI: 1982684890
Provider Name (Legal Business Name): BAKER PHARMACY LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 GREENWOOD AVE
BETHEL CT
06801-2530
US

IV. Provider business mailing address

140 GREENWOOD AVE
BETHEL CT
06801-2530
US

V. Phone/Fax

Practice location:
  • Phone: 203-744-0945
  • Fax: 203-790-4169
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number0085
License Number StateCT

VIII. Authorized Official

Name: DANIEL BOULANGER
Title or Position: PRESIDENT
Credential:
Phone: 203-244-0945