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NPI Code Detail

MEDICARE: ABH PHARMACY LLC

MEDICARE: ABH PHARMACY LLC
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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy
33336L0003XLong Term Care PharmacyPCY.0001705CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12002410OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891739645
Entity Type Code : Organization
Provider Name (Legal Business Name) : ABH PHARMACY LLC
Provider Business Mailing Address
First Line : 189 ALPS ROAD
Second Line :
City : BRANFORD
State : CT
Zip : 06405
Country : US
Telephone Number : 203-315-2634
Fax Number : 203-315-2154
Provider Business Practice Location Address
First Line : 189 ALPS RD
Second Line :
City : BRANFORD
State : CT
Zip : 06405-4771
Country : US
Telephone Number : 203-315-2634
Fax Number : 203-315-2154
Authorized Official
Title or Position : PHARMACY OFFICE MANAGER
Name : MS. MARIE N PUCCINO
Credential :
Telephone Number : 203-315-2634
Provider Enumeration Date : 06/15/2006
Last Update Date : 04/15/2024

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