Daniel Johnson, RPH

Individual provider Active NPI Pharmacist · Pawcatuck, CT

NPI 1679009088 · NPPES record last updated Dec 27, 2023

Key facts

NPI
1679009088
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
PCT 0007741 (CT)
Practice address
37 S Broad St
Pawcatuck, CT 06379-7909
Phone
(860) 599-4030
Fax
(860) 599-3640
NPI assigned
May 4, 2017
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PCT 0007741CTMDPharmacist
PCT.0007741CTMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PCT.0007741 CT
Pharmacist 183500000X PCT 0007741 CT Yes

Addresses

Primary practice location

37 S Broad St
Pawcatuck, CT 06379-7909

Mailing address

37 S Broad St
Pawcatuck, CT 06379-7909
Phone (860) 599-4030

Other providers in Pawcatuck, CT

All providers in Pawcatuck, CT · Pharmacist in Connecticut

Sources for this page

Verify at the official NPI Registry.