Healthcare Provider Details

I. General information

NPI: 1639651037
Provider Name (Legal Business Name): TRCP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2018
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 N 2ND AVE
TAFTVILLE CT
06380-1407
US

IV. Provider business mailing address

PO BOX 540
HIGGANUM CT
06441-0540
US

V. Phone/Fax

Practice location:
  • Phone: 860-383-2013
  • Fax: 860-383-2135
Mailing address:
  • Phone: 860-345-3607
  • Fax: 860-345-3612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateCT

VIII. Authorized Official

Name: CAILIN PETERSEN
Title or Position: MEMBER
Credential:
Phone: 860-383-2013