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General NPI Number Information
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NPI Number | 1093204604
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Entity Type | Organization
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Legal Business Name | NOSTRUMRX LLC
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Dates
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Enumeration Date | 05/09/2018
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Last Update Date | 01/11/2023
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Provider Practice Location Address
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Address Line | 2286 BERLIN TPKE
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City | NEWINGTON
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State | CT
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Zip | 06111-3202
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Country | US
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Telephone | 860-430-4738
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Fax | 860-757-3576
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Provider Business Mailing Address
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Address Line | 2286 BERLIN TURNPIKE
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City | NEWINGTON
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State | CT
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Zip | 06111
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Country | US
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Telephone | 860-430-4738
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Fax | 860-757-3576
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Authorized Official
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Title or Position | OWNER
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Name | RYAN MANION
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Credential | PHARM D
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Telephone | 860-343-5220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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