Healthcare Provider Details

I. General information

NPI: 1710127469
Provider Name (Legal Business Name): PARTNERS OF CONNECTICUT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2009
Last Update Date: 06/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 THOMPSON RD
EAST WINDSOR CT
06088-9626
US

IV. Provider business mailing address

6 THOMPSON RD
EAST WINDSOR CT
06088-9626
US

V. Phone/Fax

Practice location:
  • Phone: 860-793-2800
  • Fax: 860-793-2802
Mailing address:
  • Phone: 860-793-2800
  • Fax: 860-793-2802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPCY0002137
License Number StateCT

VIII. Authorized Official

Name: JOHN WALKER
Title or Position: COO
Credential:
Phone: 908-931-9111