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General NPI Number Information
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NPI Number | 1881761781
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Entity Type | Organization
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Legal Business Name | IVERY & DUDLEY INC
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 118 MAIN ST
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City | WINSTED
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State | CT
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Zip | 06098-1713
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Country | US
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Telephone | 860-738-9116
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 745
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City | WINSTED
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State | CT
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Zip | 06098-0745
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Country | US
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Telephone | 860-373-8911
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Fax | 800-856-0221
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN PHILIP PARISI
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Credential | RPH CDE
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Telephone | 860-738-9116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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