Healthcare Provider Details

I. General information

NPI: 1902908668
Provider Name (Legal Business Name): CONNECTICUT PHARMACARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 11/13/2014
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 TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPCY.0000432
License Number StateCT

VIII. Authorized Official

Name: DANIEL VENDETTI
Title or Position: TEASURER
Credential:
Phone: 203-723-1376