=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871027714
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UNITY PHARMACY II LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/18/2017
-----------------------------------------------------
Last Update Date | 08/19/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 679 FAIRFIELD AVE
-----------------------------------------------------
City | BRIDGEPORT
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06604-3906
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-870-4711
-----------------------------------------------------
Fax | 203-870-4712
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1326 POST RD
-----------------------------------------------------
City | FAIRFIELD
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06824-6012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-955-1781
-----------------------------------------------------
Fax | 203-955-1782
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. NAGA ARITA MULPURI
-----------------------------------------------------
Credential | PHARMACIST
-----------------------------------------------------
Telephone | 203-870-4711
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------