Healthcare Provider Details

I. General information

NPI: 1295459451
Provider Name (Legal Business Name): PAUL C. YEAKLEY RPH, PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2022
Last Update Date: 09/30/2022
Certification Date: 09/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 INWOOD RD STE 5
ROCKY HILL CT
06067-3441
US

IV. Provider business mailing address

56 MONTCLAIR DR
EAST HARTFORD CT
06118-3327
US

V. Phone/Fax

Practice location:
  • Phone: 860-727-4064
  • Fax: 860-727-4084
Mailing address:
  • Phone: 203-440-7546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15263
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: