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General NPI Number Information
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NPI Number | 1083012421
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Entity Type | Organization
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Legal Business Name | DIXWELL PHARMACY LLC
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Dates
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Enumeration Date | 12/17/2014
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Last Update Date | 12/17/2014
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Provider Practice Location Address
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Address Line | 2380 DIXWELL AVE
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City | HAMDEN
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State | CT
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Zip | 06514-1847
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Country | US
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Telephone | 203-281-6571
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Fax |
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Provider Business Mailing Address
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Address Line | 2380 DIXWELL AVE
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City | HAMDEN
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State | CT
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Zip | 06514-1847
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Country | US
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Telephone | 203-281-6571
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MR. NAVEEN PARUPALLI
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Credential | B.S.PHARMACY
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Telephone | 203-281-6571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PCY.0001981
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PCY.0001981
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License Number State | CT
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