Medstat Pharmacy LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

0002207 Issued in CT

Legal business name

MEDSTAT PHARMACY LLC

Doing business as

Medstat Pharmacy

Practice address

41 Northwest Dr
Plainville, CT 06062-1234

Phone

(860) 677-2934

NPI assigned

Feb 1, 2011

Last updated

Feb 24, 2012By 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

Edward Pelc

Title

VP Operations

Phone

(413) 374-9210

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Medstat Pharmacy Doing business as

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

{
    "created_epoch": "1296518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330041600000",
    "number": "1659677185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 NORTHWEST DR",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060621234",
            "telephone_number": "860-677-2934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 NORTHWEST DR",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060621234",
            "telephone_number": "860-677-2934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAT PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-01",
        "last_updated": "2012-02-24",
        "status": "A",
        "authorized_official_last_name": "PELC",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "VP OPERATIONS",
        "authorized_official_telephone_number": "413-374-9210"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CT",
            "license": "0002207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0722341",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medstat Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lynne E McMahon, LCSW
• Erin McManus
• Cristine Adams McNaney I, PSY.D.
• Zachary McPherson, RPH
• Alexis Medena
• Joel S Meiners, M.S.
• Louis Anthony Melesko Jr.
• Jennifer B Melquist, MA, LPC
• Melissa Mendez, L.C.S.W.
• Mental Health Counseling and Consultation, LLC

• Long Term Care Pharmacy in Plainville, CT
• Providers in Plainville, CT by specialty
• Long Term Care Pharmacy in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; 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.