=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750744702
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTOPHER OLENDER PHARMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/29/2016
-----------------------------------------------------
Last Update Date | 01/05/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 40 MAIN ST
-----------------------------------------------------
City | CENTERBROOK
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06409-1071
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-767-1389
-----------------------------------------------------
Fax | 860-767-1388
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 661 MAIN ST
-----------------------------------------------------
City | TORRINGTON
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06790-3602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-482-8298
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PCT.0012376
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------