Hancock Pharmacy V LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PCY.0002177 Issued in CT

Legal business name

HANCOCK PHARMACY V LLC

Practice address

644 Main St
Middletown, CT 06457-2731

Phone

(860) 346-9700

Fax

(860) 346-9702

NPI assigned

Apr 29, 2010

Last updated

Jul 29, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Sudheer GhantaNPI 1407298441

Title

Member / SP

Phone

(860) 346-9700

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sudheer Ghanta

  • Pharmacist
  • Middletown, CT
  • NPI 1407298441
  NPD (past) Authorized official

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

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406592000000",
    "number": "1457678468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "644 MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572731",
            "telephone_number": "860-346-9700",
            "fax_number": "860-346-9702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "644 MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572731",
            "telephone_number": "860-346-9700",
            "fax_number": "860-346-9702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANCOCK PHARMACY V LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-29",
        "last_updated": "2014-07-29",
        "status": "A",
        "authorized_official_last_name": "GHANTA",
        "authorized_official_first_name": "SUDHEER",
        "authorized_official_title_or_position": "MEMBER / SP",
        "authorized_official_telephone_number": "860-346-9700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "PCY0002177",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "PCY.0002177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Marie Hall, PT
• Sandra Hamedeh
• Susan M Hameline-Kasznay, LMFT
• Nakia Maureen Hamlett, PH.D.
• Nancy G Hammond, APRN
• Hancock Pharmacy V LLC (Hancock Pharmacy V)
• Meghan Hansen
• Gregory Donald Hanson, PH.D.
• Arne G Hansson, MD
• Richard Hany Jr., COTA/L

• Community/Retail Pharmacy in Middletown, CT
• Providers in Middletown, CT by specialty
• Community/Retail Pharmacy in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.