Maria Bento

Individual provider Active NPI Pharmacist · Enfield, CT

NPI 1447535455 · NPPES record last updated Oct 21, 2011

Key facts

NPI
1447535455
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
PCT.0009587 (CT)
Practice address
30 Hazard Ave
Enfield, CT 06082-3713
Phone
(860) 741-3503
Fax
(860) 741-3503
NPI assigned
Oct 21, 2011
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PCT.0009587CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Eastern Co Inc Past Accepting new patients
Walgreen Eastern Co Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PCT.0009587 CT Yes

Addresses

Primary practice location

30 Hazard Ave
Enfield, CT 06082-3713

Mailing address

30 Hazard Ave
Enfield, CT 06082-3713
Phone (860) 741-3503

Other providers in Enfield, CT

All providers in Enfield, CT · Pharmacist in Connecticut

Sources for this page

Verify at the official NPI Registry.