Douglas Chung
Individual provider Active NPI Pharmacist · Willimantic, CT
NPI 1134582703 · NPPES record last updated Apr 2, 2016
Key facts
- NPI
- 1134582703
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PCT.0005939 (CT)
- Practice address
- 1200 Main St
Willimantic, CT 06226-1908 - Phone
- (860) 456-5931
- Fax
- (860) 456-1839
- NPI assigned
- Mar 31, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCT.0005939 | CT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connecticut CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Connecticut CVS Pharmacy LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PCT.0005939 | CT | Yes |
Addresses
Primary practice location
1200 Main St
Willimantic, CT 06226-1908
Mailing address
1200 Main St
Willimantic, CT 06226-1908
Phone (860) 456-5931
Other providers in Willimantic, CT
- Change Counseling, LLC
- Julia Charpentier
- Jamie Elizabeth Charron
- Blanca D Charry
- Chelliah Pandian LLC
- Amanda Church
- Elese Ciarcia
- Marianne Ciardullo
- Donald Cieslukowski
- Deirdre M Clark
All providers in Willimantic, CT · Pharmacist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.