Active NPI
Great Hills LLC
- Community/Retail Pharmacy
- Meriden, CT
National Provider Identifier
1225490055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PCY0002333
- Legal business name
- GREAT HILLS LLC
- Practice address
- 152 Colony St Unit a
Meriden, CT 06451 - Phone
- (203) 634-3000
- Fax
- (203) 634-3001
- NPI assigned
- Mar 22, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Suresh Kurra
- Title
- Member
- Phone
- (203) 906-3993
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PCY0002333 | CT | Primary |
Addresses
Primary practice location
152 Colony St Unit a
Meriden, CT 06451
Mailing address
152 Colony Street
Unit a
Meriden, CT 06451
Phone (203) 634-3000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008064627 | Medicaid | CT | |
| 2158990 | Other | PK |
Other names 1
- Meriden Community Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Great Hills LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Meriden, CT
- NPI 1174245427
Locations
152 Colony St
Ph
Meriden, CT 06451
Phone (203) 634-3000
152 Colony St
Unit A
Meriden, CT 06451
Phone (203) 634-3000
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458604800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1493769600000",
"number": "1225490055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "152 COLONY STREET",
"address_2": "UNIT A",
"city": "MERIDEN",
"state": "CT",
"postal_code": "06451",
"telephone_number": "203-634-3000",
"fax_number": "203-634-3001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "152 COLONY ST UNIT A",
"city": "MERIDEN",
"state": "CT",
"postal_code": "06451",
"telephone_number": "203-634-3000",
"fax_number": "203-634-3001"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GREAT HILLS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-03-22",
"last_updated": "2017-05-03",
"status": "A",
"authorized_official_last_name": "KURRA",
"authorized_official_first_name": "SURESH",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "203-906-3993"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CT",
"license": "PCY0002333",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008064627",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2158990",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Meriden Community Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Meriden, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.