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1972501294

NPI Code Detail

MEDICARE: ARROW PRESCRIPTION CENTER 12 INC

MEDICARE: ARROW PRESCRIPTION CENTER 12 INC

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
1	332B00000X	Durable Medical Equipment & Medical Supplies		CT
2	332BC3200X	Customized Equipment (DME)		CT
3	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)		CT
4	332BX2000X	Oxygen Equipment & Supplies (DME)		CT
5	3336C0002X	Clinic Pharmacy	0347	CT
6	3336C0003X	Community/Retail Pharmacy	0347	CT
7	3336C0004X	Compounding Pharmacy	0347	CT
8	3336H0001X	Home Infusion Therapy Pharmacy	0347	CT
9	3336I0012X	Institutional Pharmacy	0347	CT
10	3336L0003X	Long Term Care Pharmacy	0347	CT
11	3336M0002X	Mail Order Pharmacy	0347	CT
12	3336M0003X	Managed Care Organization Pharmacy	0347	CT
13	3336S0011X	Specialty Pharmacy	0347	CT
14	335E00000X	Prosthetic/Orthotic Supplier		CT
15	333600000X	Pharmacy	0347	CT

Other Identifiers

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

General Provider Information

NPI Number	:	1972501294
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARROW PRESCRIPTION CENTER 12 INC

Provider Business Mailing Address
First Line	:	500 FARMINGTON AVE
Second Line	:
City	:	HARTFORD
State	:	CT
Zip	:	06105-3106
Country	:	US
Telephone Number	:	860-570-0543
Fax Number	:	860-570-0529

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	:	860-231-7007

Authorized Official
Title or Position	:	PRESIDENT CEO
Name	:	ANGELO DEFAZIO
Credential	:	RPH PD
Telephone Number	:	860-570-0543

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	03/13/2017

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Directions to “ARROW PRESCRIPTION CENTER 12 INC ” Practice Location

Language	Start Address	Practice Location

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