Jewett City Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PCY.0000657 Issued in CT

Legal business name

JEWETT CITY PHARMACY

Doing business as

jewett city pharmacy

Practice address

78 Main St
Jewett City, CT 06351-2226

Phone

(860) 376-4468

Fax

(860) 376-0399

NPI assigned

Aug 15, 2005

Last updated

Jul 19, 2018By 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

Tony Komari, RPH

Title

Owner/President/Pic/Ao

Phone

(860) 376-4468

Specialties & licenses 4

Addresses

Other identifiers 4

Other names 1

• jewett city pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CT2 enrollments

Enrollment records 2

Tax ID family

Jewett City Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jewett City Pharmacy

  dba Jewett City Pharmacy LTC

  • Long Term Care Pharmacy
  • Jewett City, CT
  • NPI 1609612928
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Jewett City Pharmacy

  dba Jewett City Pharmacy LTC

  • Long Term Care Pharmacy
  • Jewett City, CT
  • NPI 1609612928
  NPPES parent name

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1689676074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 MAIN ST",
            "city": "JEWETT CITY",
            "state": "CT",
            "postal_code": "063512226",
            "telephone_number": "860-376-4468",
            "fax_number": "860-376-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 MAIN ST",
            "city": "JEWETT CITY",
            "state": "CT",
            "postal_code": "063512226",
            "telephone_number": "860-376-4468",
            "fax_number": "860-376-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEWETT CITY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "KOMARI",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT/PIC/AO",
        "authorized_official_telephone_number": "860-376-4468",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "PCY.0000657",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004167971",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004032751",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004167963",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2001749",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "jewett city pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Griswold Family Chiropractic
• Haven Health Center of Jewett City, LLC
• Nancy Hinchey
• Infinity Care LLC
• Jewett City Pharmacy (Jewett City Pharmacy LTC)
• Joel Zuckerbraun Odpl
• Journey to You, LLC
• Norman G. Katzoff, DMD
• Brittany Lehmann
• Kathryn Lynn Morrison, PHARMACIST

• Community/Retail Pharmacy in Jewett City, CT
• Providers in Jewett City, 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 Jul 19, 2018; 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.