Active NPI
Anthony O Ajegba
- Pharmacist
- Hartford, CT
National Provider Identifier
1154832079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0010521
- Practice address
- 1156 Albany Ave
Hartford, CT 06112-2393 - Phone
- (860) 206-3890
- Fax
- (860) 906-1428
- NPI assigned
- Oct 18, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0010521 | CT | Primary |
Addresses
Primary practice location
1156 Albany Ave
Hartford, CT 06112-2393
Mailing address
27 Beecher LN
Rocky Hill, CT 06067-3239
Phone (860) 655-1988
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010521 | CT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kure RX Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Hartford, CT
- NPI 1811418940
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508284800000",
"number": "1154832079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 BEECHER LN",
"city": "ROCKY HILL",
"state": "CT",
"postal_code": "060673239",
"telephone_number": "860-655-1988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1156 ALBANY AVE",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061122393",
"telephone_number": "860-206-3890",
"fax_number": "860-906-1428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AJEGBA",
"first_name": "ANTHONY",
"middle_name": "O",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-10-18",
"last_updated": "2017-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "0010521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.