Organization Active NPI

Hartford Pharmacy II Inc

  • Community/Retail Pharmacy
  • Hartford, CT
National Provider Identifier
1194264820
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
HARTFORD PHARMACY II INC
Practice address
57 Park St
Hartford, CT 06106-2520
Phone
(860) 244-2222
Fax
(860) 244-2202
NPI assigned
Feb 14, 2017
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Praveen K Dhulipall
Title
V. President
Phone
(201) 270-8013

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

57 Park St
Hartford, CT 06106-2520

Mailing address

57 Park St
Hartford, CT 06106-2520
Phone (860) 244-2222

Other identifiers 4

IdentifierTypeStateIssuer
PCY.0002349OtherCTBOARD OF PHARMACY
008072753MedicaidCT
2167253OtherPK
0724369OtherNCPDP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190605001650 CT DME Supplier - Pharmacy 2668705716 Practice locations: Hartford, CT
O20201218000593 CT Part B Supplier - Pharmacy 2668705716 Practice locations: Hartford, CT

National Provider Directory

National Provider Directory

Locations

57 Park St
Hartford, CT 06106
Phone (860) 244-2222

Practitioners & affiliated clinicians

Practitioners 1

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": "1487030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1194264820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 PARK ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062520",
            "telephone_number": "860-244-2222",
            "fax_number": "860-244-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 PARK ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062520",
            "telephone_number": "860-244-2222",
            "fax_number": "860-244-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARTFORD PHARMACY II INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-14",
        "last_updated": "2023-03-07",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "DHULIPALL",
        "authorized_official_first_name": "PRAVEEN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "V. PRESIDENT",
        "authorized_official_telephone_number": "201-270-8013"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "PCY.0002349",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008072753",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167253",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0724369",
            "state": null
        }
    ],
    "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 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.