Healthcare Provider Details

I. General information

NPI: 1417315664
Provider Name (Legal Business Name): HUNTLEY PHARMACIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2016
Last Update Date: 09/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CHURCH ST
NAUGATUCK CT
06770-4112
US

IV. Provider business mailing address

2 CHURCH ST
NAUGATUCK CT
06770-4112
US

V. Phone/Fax

Practice location:
  • Phone: 203-729-2680
  • Fax: 203-720-1626
Mailing address:
  • Phone: 203-729-2680
  • Fax: 203-720-1626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number0000432
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: THOR HUNTLEY
Title or Position: CEO
Credential:
Phone: 203-723-1376