Healthcare Provider Details

I. General information

NPI: 1467361162
Provider Name (Legal Business Name): HEATHER WELFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 N EAGLEVILLE RD UNIT 3092
STORRS CT
06269-3092
US

IV. Provider business mailing address

24 NORTH AVE
NORTH HAVEN CT
06473-2708
US

V. Phone/Fax

Practice location:
  • Phone: 860-486-2129
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License NumberPCT.0015677
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: