Healthcare Provider Details
I. General information
NPI: 1619800075
Provider Name (Legal Business Name): MEDICAL CENTER PHARMACY AND HOME CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
633 MIDDLESEX TPKE
OLD SAYBROOK CT
06475-1220
US
IV. Provider business mailing address
1100 SHERMAN AVE
HAMDEN CT
06514-1363
US
V. Phone/Fax
- Phone: 860-388-8454
- Fax: 860-388-8455
- Phone: 844-881-0043
- Fax: 203-230-0679
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TINA
THAO
DO
Title or Position: ASSOCIATE DIRECTOR
Credential: PHARMD
Phone: 203-917-2243