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General NPI Number Information
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NPI Number | 1902125875
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Entity Type | Organization
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Legal Business Name | UCONN HEALTH CENTER PHARMACY
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Dates
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Enumeration Date | 05/18/2010
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Last Update Date | 05/18/2010
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Provider Practice Location Address
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Address Line | 270 FARMINGTON AVE SUITE 108
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City | FARMINGTON
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State | CT
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Zip | 06032-1909
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Country | US
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Telephone | 860-679-7915
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Fax | 860-679-8020
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Provider Business Mailing Address
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Address Line | 263 FARMINGTON AVE MC 6202
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City | FARMINGTON
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State | CT
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Zip | 06030-6202
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Country | US
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Telephone | 860-679-7920
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Fax | 860-679-8020
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR CMHC
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Name | DR. ROBERT TRESTMAN
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Credential | MD
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Telephone | 860-679-5596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 0065
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License Number State | CT
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