Healthcare Provider Details

I. General information

NPI: 1073678496
Provider Name (Legal Business Name): ARYAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 03/07/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

774 FARMINGTON AVE
WEST HARTFORD CT
06119-1615
US

IV. Provider business mailing address

774 FARMINGTON AVE
WEST HARTFORD CT
06119-1615
US

V. Phone/Fax

Practice location:
  • Phone: 860-232-4595
  • Fax: 860-236-9525
Mailing address:
  • Phone: 860-232-4595
  • Fax: 860-236-9525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number004267482
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number2084
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPCY2084
License Number StateCT

VIII. Authorized Official

Name: YEHIA ARYAN
Title or Position: OWNER PHARMACIST
Credential: RPH
Phone: 860-232-4595