Waterbury Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

WATERBURY PHARMACY LLC

Doing business as

Waterbury Pharmacy

Practice address

187 E Main St
Waterbury, CT 06702-2300

Phone

(203) 757-2000

Fax

(203) 757-2002

NPI assigned

Apr 27, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Praveen K Dhulipalla, RPH

Title

Manager

Phone

(201) 270-8013

Specialties & licenses 2

Addresses

Other names 1

• Waterbury Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CT2 enrollments

Enrollment records 2

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1487898060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022300",
            "telephone_number": "203-757-2000",
            "fax_number": "203-757-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022300",
            "telephone_number": "203-757-2000",
            "fax_number": "203-757-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERBURY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-27",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "DHULIPALLA",
        "authorized_official_first_name": "PRAVEEN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "201-270-8013",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waterbury Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Waterbury Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Waterbury Health Operations Corp.
• Waterbury Hospital
• Waterbury Medical Equip Supply Inc
• Waterbury Orthopaedic Associates P C
• Waterbury Orthopaedic Associates PC
• Waterbury Pharmacy LLC
• Waterbury Podiatry Consultants
• Waterbury Psychiatric Associates, P.C.
• Waterbury Pulmonary Associates
• Waterbury Radiation Oncology Associates, PC

• Community/Retail Pharmacy in Waterbury, CT
• Providers in Waterbury, 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 Mar 7, 2023; 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.