Organization Active NPI

Atwater Pharmacy LLC

  • Community/Retail Pharmacy
  • New Haven, CT
National Provider Identifier
1013772870
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ATWATER PHARMACY LLC
Practice address
135 Grand Ave
New Haven, CT 06513-3939
Phone
(203) 923-3229
NPI assigned
Feb 20, 2024
Last updated
Feb 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Manthena Varma
Title
Member
Phone
(203) 923-3229

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

135 Grand Ave
New Haven, CT 06513-3939

Mailing address

72 Grand Ave
New Haven, CT 06513-3997

National Provider Directory

National Provider Directory

Locations

135 Grand Ave
New Haven, CT 06513
Phone (203) 923-3229

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1013772870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 GRAND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 GRAND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133939",
            "telephone_number": "203-923-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATWATER PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "VARMA",
        "authorized_official_first_name": "MANTHENA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "203-923-3229"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.