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General NPI Number Information
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NPI Number | 1699612226
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Entity Type | Organization
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Legal Business Name | 175 MAIN STREET PHARMACY LLC
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Dates
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Enumeration Date | 05/01/2026
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Last Update Date | 05/01/2026
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Provider Practice Location Address
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Address Line | 175 MAIN ST
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City | HARTFORD
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State | CT
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Zip | 06106-1818
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Country | US
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Telephone | 860-856-9501
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Fax | 860-856-9502
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Provider Business Mailing Address
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Address Line | 269 POST ROAD, PMB 852258
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City | FAIRFIELD
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State | CT
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Zip | 06824-6220
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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 | MANAGER
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Name | SANDRA JAMRON
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Credential |
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Telephone | 917-921-5838
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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 |
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License Number State |
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Taxonomy #2
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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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