Healthcare Provider Details

I. General information

NPI: 1952011447
Provider Name (Legal Business Name): HANCOCK PHARMACY AT CANAAN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2022
Last Update Date: 11/25/2022
Certification Date: 11/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 S CANAAN RD
CANAAN CT
06018-2502
US

IV. Provider business mailing address

99 S CANAAN RD
CANAAN CT
06018-2502
US

V. Phone/Fax

Practice location:
  • Phone: 860-824-3822
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: GREGORY HANCOCK
Title or Position: PRESIDENT
Credential:
Phone: 203-235-6323