Woodmark Pharmacy of CT LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PCY2366 Issued in CT

Legal business name

WOODMARK PHARMACY OF CT LLC

Practice address

41 Northwest Dr
Plainville, CT 06062-1234

Phone

(860) 846-6369

Fax

(860) 996-2086

NPI assigned

Dec 20, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Rubin

Title

Co-Chief Executive Officer

Phone

(716) 817-5075

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Woodmark Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bruce Robert Dickerman, RPH

  • Pharmacist
  • Old Saybrook, CT
  • NPI 1477861581
  NPD
• Edward John Pelc Jr., RPH

  • Pharmacist
  • South Hadley, MA
  • NPI 1023326212
  NPD

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1194231571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SENECA ST STE 100",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142041963",
            "telephone_number": "716-633-3900",
            "fax_number": "860-996-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 NORTHWEST DR",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060621234",
            "telephone_number": "860-846-6369",
            "fax_number": "860-996-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODMARK PHARMACY OF CT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-20",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CO-CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "716-817-5075",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CT",
            "license": "PCY2366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176188",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodmark Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Wills, APRN
• Rachel Kate Wilson
• David A Winokur
• Stacy Ann Witter, LMSW
• Beth A Wolff, PT, DPT
• Lenora Woods
• Catherine Mauser Worth, MSW STUDENT
• Wrobel Wellness Group, LLC
• Shuo-Chieh Wu
• Kayla Wyant

• Long Term Care Pharmacy in Plainville, CT
• Providers in Plainville, CT by specialty
• Long Term Care Pharmacy in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.