Candlewood Drugs

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PCY.0002167 Issued in CT

Legal business name

CANDLEWOOD DRUGS

Doing business as

CANDLEWOOD DRUGS

Practice address

11 State Route 37
New Fairfield, CT 06812-4028

Phone

(203) 312-9999

Fax

(203) 746-6789

NPI assigned

Apr 8, 2010

Organization subpart

No

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

Authorized official

Name

Miss Sirisha MallidiNPI 1053588996

Title

Pharmacist

Phone

(203) 312-9999

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 2

• CANDLEWOOD DRUGS Doing business as
• candlewood drugs llc Other name

Medicare fee-for-service enrollment

Enrolled in CT3 enrollments

Enrollment records 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

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

• Sirisha Mallidi, RPH

  • Pharmacist
  • Monroe, NY
  • NPI 1053588996
  NPD Authorized official

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611878400000",
    "number": "1780900233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 STATE ROUTE 37",
            "city": "NEW FAIRFIELD",
            "state": "CT",
            "postal_code": "068124028",
            "telephone_number": "203-312-9999",
            "fax_number": "203-746-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 STATE ROUTE 37",
            "city": "NEW FAIRFIELD",
            "state": "CT",
            "postal_code": "068124028",
            "telephone_number": "203-312-9999",
            "fax_number": "203-746-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANDLEWOOD DRUGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-08",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A",
        "authorized_official_last_name": "MALLIDI",
        "authorized_official_first_name": "SIRISHA",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "203-312-9999",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "0002167",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "PCY.0002167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008017664",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD LICENSE NUMBER",
            "identifier": "PCY.0002167",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CANDLEWOOD DRUGS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "candlewood drugs llc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lorraine Burio, D.M.D.
• Susan Byrnes, LCSW
• Robyn P Campagniolo
• Kate Lynn Campbell, DPT
• Candlewood Dental Care Inc
• Candlewood Gentle Dental
• Candlewood Pharmacy
• Candlewood Physical Therapy and Fitness, LLC
• Kyle Marie Cervone, BCBA
• Sandra Marion Chester

• Community/Retail Pharmacy in New Fairfield, CT
• Providers in New Fairfield, 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 Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.