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General NPI Number Information
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NPI Number | 1396709853
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Entity Type | Organization
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Legal Business Name | HIGH RIDGE ROAD DRUG CORPORATION
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 1055 HIGH RIDGE RD
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City | STAMFORD
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State | CT
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Zip | 06905-1121
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Country | US
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Telephone | 203-322-7654
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Fax | 203-968-9868
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Provider Business Mailing Address
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Address Line | 1055 HIGH RIDGE RD
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City | STAMFORD
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State | CT
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Zip | 06905-1121
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Country | US
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Telephone | 203-322-7654
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Fax | 203-968-9868
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Authorized Official
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Title or Position | OWNER AND RPH
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Name | PHILIP JAMES MAYO
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Credential | RPH
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Telephone | 203-322-7654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 677
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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 |
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License Number State |
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