NPIMap

Organization Active NPI

Compounded Solutions in Pharmacy, LLC

  • Pharmacist
  • Monroe, CT
National Provider Identifier
1164639431
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
1717 Issued in CT
Legal business name
COMPOUNDED SOLUTIONS IN PHARMACY, LLC
Practice address
179 Main St
Monroe, CT 06468-1107
Phone
(203) 268-4964
Fax
(203) 268-5492
NPI assigned
May 17, 2007
Last updated
Jul 19, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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

Authorized official

Name
Michael Roberge, RPHNPI 1801871090
Title
Principal Member
Phone
(203) 268-4964

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 1717 CT Primary

Addresses

Primary practice location

179 Main St
Monroe, CT 06468-1107

Mailing address

179 Main St
Monroe, CT 06468-1107
Phone (203) 268-4964

Other identifiers 1

IdentifierTypeStateIssuer
4216265MedicaidCT

National Provider Directory

National Provider Directory

Locations

179 Main St
Monroe, CT 06468
Phone (203) 268-4964

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184803200000",
    "number": "1164639431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 MAIN ST",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064681107",
            "telephone_number": "203-268-4964",
            "fax_number": "203-268-5492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 MAIN ST",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064681107",
            "telephone_number": "203-268-4964",
            "fax_number": "203-268-5492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPOUNDED SOLUTIONS IN PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-19",
        "status": "A",
        "authorized_official_last_name": "ROBERGE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRINCIPAL MEMBER",
        "authorized_official_telephone_number": "203-268-4964",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "1717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4216265",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.