Healthcare Provider Details

I. General information

NPI: 1437144185
Provider Name (Legal Business Name): REDDING PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 07/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 REDDING RD
GEORGETOWN CT
06829-0359
US

IV. Provider business mailing address

PO BOX 359
GEORGETOWN CT
06829-0359
US

V. Phone/Fax

Practice location:
  • Phone: 203-544-8306
  • Fax: 203-544-9268
Mailing address:
  • Phone: 203-544-8306
  • Fax: 203-544-9268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number0001702
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number0001702
License Number StateCT

VIII. Authorized Official

Name: MR. PINHANN DANIEL LIU
Title or Position: PHARMACY OWNER/MANAGER
Credential: R.PH
Phone: 203-544-8306