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General NPI Number Information
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NPI Number | 1609953348
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Entity Type | Organization
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Legal Business Name | PORTER & GIRGASKY, INC.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 682 MAIN ST S
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City | WOODBURY
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State | CT
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Zip | 06798-3736
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Country | US
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Telephone | 203-263-2282
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Fax | 203-263-4030
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Provider Business Mailing Address
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Address Line | 682 MAIN ST S P.O. BOX 388
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City | WOODBURY
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State | CT
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Zip | 06798-3736
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Country | US
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Telephone | 203-263-2282
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Fax | 203-263-4030
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Authorized Official
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Title or Position | PRESIDENT
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Name | JANE E GIRGASKY
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Credential | RPH
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Telephone | 203-263-2282
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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 | 1712
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License Number State | CT
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