Enfield Compounding Pharmacy LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

2362 Issued in CT

Legal business name

ENFIELD COMPOUNDING PHARMACY LLC

Doing business as

ENFIELD COMPOUNDING PHARMACY

Practice address

139 Hazard Ave BLDG 4
Enfield, CT 06082-4585

Phone

(860) 749-1101

Fax

(860) 749-1106

NPI assigned

Mar 14, 2018

Organization subpart

No

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

Authorized official

Name

Frank Page

Title

Pharmacist/Owner

Phone

(860) 749-1101

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• ENFIELD COMPOUNDING PHARMACY Doing business as

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1568965796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1152",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060831152",
            "telephone_number": "860-749-1101",
            "fax_number": "860-749-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 HAZARD AVE BLDG 4",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824585",
            "telephone_number": "860-749-1101",
            "fax_number": "860-749-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENFIELD COMPOUNDING PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-14",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "PAGE",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "860-749-1101"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "CT",
            "license": "2362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176935",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ENFIELD COMPOUNDING PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alyse Marie Enderle
• Travis Ji Enders
• Enfield Ambulatory Care Center LLC
• Enfield Club Properties, LLC
• Enfield Compounding Center LLC
• Enfield Dermatology LLC
• Enfield Eyecare Associates, L.L.P.
• Enfield Pediatric Associates,P.C.
• Enfield Pediatric Dentistry LLC
• Enfield Plaza Family Dental

• Compounding Pharmacy in Enfield, CT
• Providers in Enfield, CT by specialty
• Compounding Pharmacy in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.