Samantha Anne Fraczek

Primary specialty

PharmacistTaxonomy code 183500000X

License

PCT.0014890 Issued in CT

Practice address

597 Farmington Ave
Bristol, CT 06010

Phone

(860) 582-4080

NPI assigned

Aug 21, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Samantha Anne Copeland Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Stop and Shop Supermarket Co LLC

  • Community/Retail Pharmacy
  • Bristol, CT
  • NPI 1972535839
  NPD (past)

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1215584677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "597 FARMINGTON AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "06010",
            "telephone_number": "203-200-9688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "597 FARMINGTON AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "06010",
            "telephone_number": "860-582-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRACZEK",
        "first_name": "SAMANTHA",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-21",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0014890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "samantha.copeland@stopandshop.com",
            "affiliation": "Y",
            "affiliationName": "The Stop & Shop Supermarket Company LLC",
            "address_1": "206 Kitts Ln",
            "city": "Newington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061114250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "COPELAND",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Blake Forkey, DO
• Angela Fortune, PHARMD
• Jeffrey Scott Fouche-Camargo, DNP, APRN
• Edward Robert Fournier Jr., DMD
• Daniel Fox, PHARM D
• Ralph J. Frank Jr., R.PH., M.P.H.
• John Arthur Frazier, M.D.
• Laura Michelle Frechette
• Marisela Frias
• Hilary Frisch

• Pharmacist in Bristol, CT
• Providers in Bristol, CT by specialty
• Pharmacist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; 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.