Healthcare Provider Details

I. General information

NPI: 1629077912
Provider Name (Legal Business Name): ARROW PRESCRIPTION CENTER 14 INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 01/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WOODLAND ST
HARTFORD CT
06105-1223
US

IV. Provider business mailing address

100 WOODLAND ST
HARTFORD CT
06105-1223
US

V. Phone/Fax

Practice location:
  • Phone: 860-527-2800
  • Fax: 860-527-1381
Mailing address:
  • Phone: 860-527-2800
  • Fax: 860-527-1381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPCY.0001117
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANGELO DEFAZIO
Title or Position: PRESIDENT
Credential:
Phone: 860-527-2800