Healthcare Provider Details

I. General information

NPI: 1588902563
Provider Name (Legal Business Name): CT HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2013
Last Update Date: 05/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 BROAD ST
NEW BRITAIN CT
06053-4305
US

IV. Provider business mailing address

46 BROAD ST
NEW BRITAIN CT
06053-4305
US

V. Phone/Fax

Practice location:
  • Phone: 860-223-0522
  • Fax: 860-223-0822
Mailing address:
  • Phone: 860-223-0522
  • Fax: 860-223-0822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPCY0002260
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SURESH BABU KURRA
Title or Position: MEMBER
Credential:
Phone: 860-223-0522