Active NPI
Donald Diange, RPH
- Pharmacist
- Willimantic, CT
National Provider Identifier
1194268490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PCT.0005492
- Practice address
- 1391 Main Street
Willimantic, CT 06226 - Phone
- (860) 456-7240
- Fax
- (860) 423-0219
- NPI assigned
- Nov 18, 2016
- Last updated
- Nov 18, 2016
- 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 | PCT.0005492 | CT | Primary |
Addresses
Primary practice location
1391 Main Street
Willimantic, CT 06226
Mailing address
1391 Main Street
Willimantic, CT 06226
Phone (860) 456-7240
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCT.0005492 | CT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Stop & Shop Supermarket Company, LLC | Past | Accepting new patients | |
| Stop and Shop Supermarket Co LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Stop and Shop Pharmacy #674
- Community/Retail Pharmacy
- Willimantic, CT
- NPI 1528090487
-
dba Stop & Shop Pharmacy 2818
- Community/Retail Pharmacy
- Kinnelon, NJ
- NPI 1932570363
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479427200000",
"number": "1194268490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1391 MAIN STREET",
"city": "WILLIMANTIC",
"state": "CT",
"postal_code": "06226",
"telephone_number": "860-456-7240",
"fax_number": "860-423-0219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1391 MAIN STREET",
"city": "WILLIMANTIC",
"state": "CT",
"postal_code": "06226",
"telephone_number": "860-456-7240",
"fax_number": "860-423-0219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIANGE",
"first_name": "DONALD",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-11-18",
"last_updated": "2016-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT.0005492",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Willimantic, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.