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General NPI Number Information
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NPI Number | 1982856944
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Entity Type | Organization
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Legal Business Name | MANCHESTER PHARMACY, LLC
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 10/21/2008
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Provider Practice Location Address
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Address Line | 348 MAIN ST
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City | MANCHESTER
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State | CT
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Zip | 06040-4123
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Country | US
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Telephone | 860-649-1025
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Fax |
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Provider Business Mailing Address
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Address Line | 348 MAIN ST
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City | MANCHESTER
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State | CT
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Zip | 06040-4123
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Country | US
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Telephone | 860-649-1025
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | ANIL PILIGILLA
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Credential | RPH
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Telephone | 860-649-1025
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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 | PCY-0001290
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License Number State | CT
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