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NPI Code Detail

MEDICARE: JILL T ST. GERMAIN PHARMD

MEDICARE: JILL T ST. GERMAIN PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist10812CT

General Provider Information

NPI Number : 1356626378
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL T ST. GERMAIN PHARMD
Provider Business Mailing Address
First Line : 500 FARMINGTON AVE
Second Line :
City : HARTFORD
State : CT
Zip : 06105-3106
Country : US
Telephone Number : 860-522-9289
Fax Number :
Provider Business Practice Location Address
First Line : 500 FARMINGTON AVE
Second Line :
City : HARTFORD
State : CT
Zip : 06105-3106
Country : US
Telephone Number : 860-522-9289
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2011
Last Update Date : 11/04/2011

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Directions to “ JILL T ST. GERMAIN PHARMD” Practice Location

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