Active NPI
Elizabeth Rettig, RPH
- Pharmacist
- Willimantic, CT
National Provider Identifier
1245838721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PCT0009319
- Practice address
- 1197 Main St
Willimantic, CT 06226-1907 - Phone
- (860) 423-1661
- Fax
- (860) 423-1200
- NPI assigned
- Oct 15, 2020
- Last updated
- Oct 15, 2020
- Sex
- Female
- 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 | PCT0009319 | CT | Primary |
Addresses
Primary practice location
1197 Main St
Willimantic, CT 06226-1907
Mailing address
208 Tripp Hollow Rd
Brooklyn, CT 06234-2321
Phone (860) 455-8720
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 |
|---|---|---|---|
| PCT0009319 | CT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Para-Pharm Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602720000000",
"number": "1245838721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 TRIPP HOLLOW RD",
"city": "BROOKLYN",
"state": "CT",
"postal_code": "062342321",
"telephone_number": "860-455-8720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1197 MAIN ST",
"city": "WILLIMANTIC",
"state": "CT",
"postal_code": "062261907",
"telephone_number": "860-423-1661",
"fax_number": "860-423-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RETTIG",
"first_name": "ELIZABETH",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-15",
"last_updated": "2020-10-15",
"certification_date": "2020-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT0009319",
"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 Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.