MEDICARE: WASSEF 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
1	3336L0003X	Long Term Care Pharmacy
2	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1992189146
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WASSEF LLC

Provider Business Mailing Address
First Line	:	535 BOSTON POST RD
Second Line	:
City	:	OLD SAYBROOK
State	:	CT
Zip	:	06475-1506
Country	:	US
Telephone Number	:	860-449-3097
Fax Number	:	860-442-4513

Provider Business Practice Location Address
First Line	:	535 BOSTON POST RD
Second Line	:
City	:	OLD SAYBROOK
State	:	CT
Zip	:	06475-1506
Country	:	US
Telephone Number	:	860-449-3097
Fax Number	:	860-442-4513

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. NAGY WASSEF
Credential	:	RPH
Telephone Number	:	860-449-3097

Provider Enumeration Date	:	07/17/2015
Last Update Date	:	07/17/2015

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Directions to “WASSEF LLC ” Practice Location

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