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General NPI Number Information
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NPI Number | 1679600746
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Entity Type | Organization
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Legal Business Name | MEDICAL CENTER PHARMACY AND HOME CARE CENTER, INC.
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 05/12/2022
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Provider Practice Location Address
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Address Line | 1450 CHAPEL ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-4405
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Country | US
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Telephone | 203-789-4076
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Fax | 203-867-5593
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Provider Business Mailing Address
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Address Line | 1450 CHAPEL ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-4405
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Country | US
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Telephone | 203-789-4076
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Fax | 203-867-5593
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Authorized Official
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Title or Position | ASSOCIATE DIRECTOR
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Name | NICHOLAS LARIVIERE
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Credential | PHARMD
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Telephone | 203-747-7589
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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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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PCY.0002086
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License Number State | CT
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