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General NPI Number Information
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NPI Number | 1013190776
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Entity Type | Organization
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Legal Business Name | PHARMACITY LLC
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Dates
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Enumeration Date | 12/17/2007
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Last Update Date | 07/15/2009
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Provider Practice Location Address
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Address Line | 1232 STORRS RD STE 6
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City | STORRS MANSFIELD
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State | CT
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Zip | 06268-2232
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Country | US
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Telephone | 860-429-9365
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Fax | 860-429-0043
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Provider Business Mailing Address
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Address Line | 1232 STORRS RD STE 6
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City | STORRS MANSFIELD
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State | CT
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Zip | 06268-2232
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Country | US
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Telephone | 860-429-9365
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Fax | 860-429-0043
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Authorized Official
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Title or Position | OWNER
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Name | NAUFEL TAJUDEEN
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Credential |
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Telephone | 732-766-1151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PCY0000645
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License Number State | CT
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