West River Pharm of Connecticut LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PCY.0002207 Issued in CT

Legal business name

WEST RIVER PHARM OF CONNECTICUT LLC

Doing business as

West River Rx

Practice address

41 Northwest Dr
Plainville, CT 06062-1234

Phone

(860) 677-2934

Fax

(860) 351-5110

NPI assigned

Aug 12, 2015

Organization subpart

No

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

Authorized official

Name

Edward Pelc

Title

Exec VP of Pharmacy

Phone

(860) 351-5093

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• West River Rx Doing business as

Locations

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1427424555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 NORTHWEST DR",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060621234",
            "telephone_number": "860-677-2934",
            "fax_number": "860-351-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 NORTHWEST DR",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060621234",
            "telephone_number": "860-677-2934",
            "fax_number": "860-351-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST RIVER PHARM OF CONNECTICUT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-12",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "PELC",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "EXEC VP OF PHARMACY",
        "authorized_official_telephone_number": "860-351-5093"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CT",
            "license": "PCY.0002207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2153797",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West River Rx",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in Plainville, CT
• Providers in Plainville, CT by specialty
• Long Term Care Pharmacy in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.

Verify at the official NPI Registry.