Hancock Pharmacy II LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PCY.0002165 Issued in CT

Legal business name

HANCOCK PHARMACY II LLC

Practice address

1020 Fairfield Ave
Bridgeport, CT 06605-1187

Phone

(203) 576-9000

Fax

(203) 576-9010

NPI assigned

Mar 17, 2010

Reactivated

Nov 20, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Rama Lakshmi Devadi, RPH

Title

Pharmacy Manager Aka SP

Phone

(203) 576-9000

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Hancock Pharmacy II Doing business as

Medicare fee-for-service enrollment

Enrolled in CT2 enrollments

Enrollment records 2

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1154645356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 FAIRFIELD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051187",
            "telephone_number": "203-576-9000",
            "fax_number": "203-576-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 FAIRFIELD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051187",
            "telephone_number": "203-576-9000",
            "fax_number": "203-576-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANCOCK PHARMACY II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-17",
        "last_updated": "2023-03-07",
        "certification_date": "2021-02-25",
        "deactivation_date": "2020-11-06",
        "reactivation_date": "2020-11-20",
        "status": "A",
        "authorized_official_last_name": "DEVADI",
        "authorized_official_first_name": "RAMA",
        "authorized_official_middle_name": "LAKSHMI",
        "authorized_official_title_or_position": "PHARMACY MANAGER AKA SP",
        "authorized_official_telephone_number": "203-576-9000",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "PCY.0002165",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "PCY.0002165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "721882",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1154645356",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "PCY.0002165",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hancock Pharmacy II",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hancock Pharmacy II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Clive L Hamilton, D.D.S.
• Melissa Hamilton
• Selena Hammie, LPCA
• Parker G Hampson, LPC
• Sandra Marie Hamway, CRNA-DNP
• Hancock Pharmacy II LLC
• Hancock Pharmacy III, LLC
• Hancock Pharmacy III, LLC
• Hand Therapy Associates, Inc
• Wanda Juarros Hanlon, M.D.

• Community/Retail Pharmacy in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Community/Retail Pharmacy in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.