Organization Active NPI

Norwalk Pharmacy LLC

  • Community/Retail Pharmacy
  • Norwalk, CT
National Provider Identifier
1134445810
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PCY0002172 Issued in CT
Legal business name
NORWALK PHARMACY LLC
Practice address
250 Westport Ave
Norwalk, CT 06851-4158
Phone
(203) 956-0526
Fax
(203) 956-0528
NPI assigned
Apr 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Authorized official

Name
Mr. Kenneth Y Lee
Title
Pharmacy Manager
Phone
(203) 956-0526

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X PCY0002172 CT Primary

Addresses

Primary practice location

250 Westport Ave
Norwalk, CT 06851-4158

Mailing address

250 Westport Ave
Norwalk, CT 06851-4158
Phone (203) 956-0526

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20140609001955 CT DME Supplier - Pharmacy 6901020106 Practice locations: Norwalk, CT
O20161102002659 CT Part B Supplier - Mass Immunization (Roster Biller Only) 6901020106 Practice locations: Norwalk, CT
O20201203002039 CT Part B Supplier - Pharmacy 6901020106 Practice locations: Norwalk, CT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Norwalk Pharmacy250 Westport Ave, Norwalk, CT 06851-4158(203) 956-0526 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jun 9, 2014

National Provider Directory

National Provider Directory

Locations

250 Westport Ave
Norwalk, CT 06851
Phone (203) 956-0526

250 Westport Ave
Ste 4
Norwalk, CT 06851
Phone (203) 956-0526

NPI Registry JSON

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416268800000",
    "number": "1134445810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 WESTPORT AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068514158",
            "telephone_number": "203-956-0526",
            "fax_number": "203-956-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 WESTPORT AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068514158",
            "telephone_number": "203-956-0526",
            "fax_number": "203-956-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORWALK PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-20",
        "last_updated": "2014-11-18",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "203-956-0526",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "PCY0002172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.