Connecticut Pharmacy LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

0002254 Issued in CT

Legal business name

CONNECTICUT PHARMACY LLC

Doing business as

Connecticut Pharmacy
Connecticut Pharmacy LLC

Practice address

664 Main Ave Unit B101-102
Norwalk, CT 06851-1162

Phone

(203) 939-1790

Fax

(203) 939-1789

NPI assigned

Dec 7, 2012

Last updated

Oct 29, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Scott Wolak, RPHNPI 1639768468

Title

President/Ceo

Phone

(203) 518-1146

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 2

• CONNECTICUT PHARMACY Doing business as
• Connecticut Pharmacy LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in CT2 enrollments

Enrollment records 2

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Scott Wolak, RPH

  • Pharmacist
  • Norwalk, CT
  • NPI 1639768468
  Authorized official Same address or phone
• Bryan M Lentini

  • Pharmacist
  • Norwalk, CT
  • NPI 1689250268
  NPD

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

{
    "created_epoch": "1354838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540771200000",
    "number": "1063757631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BISHOP RD",
            "city": "OXFORD",
            "state": "CT",
            "postal_code": "064781597",
            "telephone_number": "203-888-5454",
            "fax_number": "203-828-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 MAIN AVE UNIT B101-102",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511162",
            "telephone_number": "203-939-1790",
            "fax_number": "203-939-1789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-07",
        "last_updated": "2018-10-29",
        "status": "A",
        "authorized_official_last_name": "WOLAK",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "203-518-1146",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CT",
            "license": "0002254",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0722973",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008043469",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CONNECTICUT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Connecticut Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in Norwalk, CT
• Providers in Norwalk, CT by specialty
• Long Term Care Pharmacy in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.