W.H. Pickett Drug Co

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

421 Issued in CT

Legal business name

W.H. PICKETT DRUG CO

Practice address

675 N Main St
Waterbury, CT 06704-3508

Phone

(203) 753-5158

Fax

(203) 597-0625

NPI assigned

Jul 29, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Edward Stukshis, RPHNPI 1881116622

Title

President

Phone

(203) 753-5158

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward John Stukshis

  • Pharmacist
  • Waterbury, CT
  • NPI 1881116622
  NPD Authorized official
• Robert Tanguay, CPHT

  • Pharmacy Technician
  • Waterbury, CT
  • NPI 1730779935
  NPD

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1669486940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 N MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067043508",
            "telephone_number": "203-753-5158",
            "fax_number": "203-597-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067043508",
            "telephone_number": "203-753-5158",
            "fax_number": "203-597-0625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W.H. PICKETT DRUG CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "STUKSHIS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-753-5158",
        "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": "CT",
            "license": "421",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004028148",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maryia Vladykina, MD
• Kristopher Ilija Vlahovic, MD
• Janet L Vodra, MD
• David Vogel, M.D.
• Jennifer Volpe
• Beverly Waczek
• Penina Wagshall
• Alan S. Waitze, M.D.
• Chana Wakszul, SLP
• Wal-Mart Stores East LP

• 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 Sep 29, 2008; 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.