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General NPI Number Information
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NPI Number | 1669105466
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Entity Type | Organization
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Legal Business Name | ABH PHARMACY LLC
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Dates
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Enumeration Date | 07/08/2022
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Last Update Date | 10/31/2022
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Provider Practice Location Address
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Address Line | 189 ALPS RD
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City | BRANFORD
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State | CT
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Zip | 06405-4771
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Country | US
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Telephone | 203-325-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 494 ELM ST
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City | STAMFORD
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State | CT
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Zip | 06902-5115
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | MS. MARIE N PUCCINO
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Credential |
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Telephone | 203-315-2634
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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 |
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License Number State |
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