Healthcare Provider Details

I. General information

NPI: 1376649186
Provider Name (Legal Business Name): SOUSA'S PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1881 PARK ST
HARTFORD CT
06106-2118
US

IV. Provider business mailing address

1881 PARK ST
HARTFORD CT
06106-2118
US

V. Phone/Fax

Practice location:
  • Phone: 860-523-4281
  • Fax: 860-236-0255
Mailing address:
  • Phone: 860-523-4281
  • Fax: 860-236-0255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number532
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number532
License Number StateCT

VIII. Authorized Official

Name: FRANK SIMAO SOUSA
Title or Position: PRESIDENT
Credential: RPH
Phone: 860-523-4281