NPIMap

Organization Active NPI

West Haven Pharmacy, LLC

  • Community/Retail Pharmacy
  • West Haven, CT
National Provider Identifier
1437561990
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2294 Issued in CT
Legal business name
WEST HAVEN PHARMACY, LLC
Practice address
764 Campbell Ave
West Haven, CT 06516-3786
Phone
(203) 974-7100
Fax
(203) 974-7103
NPI assigned
Jun 2, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Authorized official

Name
Mr. Chandra S Vipparla
Title
Vice President
Phone
(203) 934-7100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X PCY2294 CT
Community/Retail Pharmacy 3336C0003X 2294 CT Primary

Addresses

Primary practice location

764 Campbell Ave
West Haven, CT 06516-3786

Mailing address

764 Campbell Ave
Unit-a
New Haven, CT 06513
Phone (203) 934-7100

Other names 1

  • West Haven Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150304000996 CT DME Supplier - Pharmacy 9739405036 Practice locations: West Haven, CT
O20230921001323 CT Part B Supplier - Pharmacy 9739405036 Practice locations: West Haven, CT

National Provider Directory

National Provider Directory

Locations

764 Campbell Ave
Ste A
West Haven, CT 06516
Phone (203) 934-7100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1437561990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 CAMPBELL AVE",
            "address_2": "UNIT-A",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06513",
            "telephone_number": "203-934-7100",
            "fax_number": "203-934-7104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 CAMPBELL AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065163786",
            "telephone_number": "203-974-7100",
            "fax_number": "203-974-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST HAVEN PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-02",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "VIPPARLA",
        "authorized_official_first_name": "CHANDRA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "203-934-7100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "PCY2294",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "2294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Haven Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.