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General NPI Number Information
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NPI Number | 1952061939
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Entity Type | Organization
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Legal Business Name | PHARMACYATBBSQUARE LLC
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Dates
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Enumeration Date | 12/18/2021
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 55 ISHAM RD
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City | WEST HARTFORD
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State | CT
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Zip | 06107-2205
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Country | US
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Telephone | 860-656-6229
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Fax | 860-968-0013
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Provider Business Mailing Address
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Address Line | 55 ISHAM RD
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City | WEST HARTFORD
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State | CT
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Zip | 06107-2205
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Country | US
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Telephone | 860-656-6229
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Fax | 860-968-0013
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. SHOSHANA KATAYEV
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Credential | PHARMD
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Telephone | 860-656-6229
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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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