Active NPI
Dean Michael Woodruff, RPH
- Pharmacist
- Waterbury, CT
National Provider Identifier
1659654291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6634
- Practice address
- 649 W Main St
Waterbury, CT 06702-1082 - Phone
- (203) 757-6010
- NPI assigned
- Sep 20, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6634 | CT | Primary |
Addresses
Primary practice location
649 W Main St
Waterbury, CT 06702-1082
Mailing address
56 Strawberry LN
Southington, CT 06489-3905
Phone (860) 628-4729
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6634 | CT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Eastern Co, Inc | Past | Accepting new patients | |
| Walgreen Eastern Co Inc | Past | Accepting new patients |
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.
-
- Pharmacy
- Waterbury, CT
- NPI 1548275894
-
- Pharmacy
- Brookhaven, PA
- NPI 1215942206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316476800000",
"number": "1659654291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 STRAWBERRY LN",
"city": "SOUTHINGTON",
"state": "CT",
"postal_code": "064893905",
"telephone_number": "860-628-4729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "649 W MAIN ST",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067021082",
"telephone_number": "203-757-6010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODRUFF",
"first_name": "DEAN",
"middle_name": "MICHAEL",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-20",
"last_updated": "2011-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "6634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.