Healthcare Provider Details

I. General information

NPI: 1407837081
Provider Name (Legal Business Name): JOHN ARTHUR OHLUND R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 W MAIN ST
ROCKVILLE CT
06066-3501
US

IV. Provider business mailing address

1636 SOUTH ST BOX #914
COVENTRY CT
06238-3224
US

V. Phone/Fax

Practice location:
  • Phone: 860-875-9263
  • Fax: 860-871-7142
Mailing address:
  • Phone: 860-742-7819
  • Fax: 860-871-7142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5049
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: