Chartwell Southern New England, LLC

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

License

1385 Issued in CT

Legal business name

CHARTWELL SOUTHERN NEW ENGLAND, LLC

Practice address

80 Clark Dr
Unite 1-a
East Berlin, CT 06023-1157

Phone

(800) 755-1511

Fax

(860) 828-0029

NPI assigned

Jun 8, 2006

Organization subpart

No

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

Authorized official

Name

Joseph Bonaccorsi, JD

Title

Managing Member

Phone

(847) 229-7794

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Option Care Doing business as

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Option Care Enterprises, Inc.

  • Home Infusion Therapy Pharmacy
  • Chantilly, VA
  • NPI 1679896989

  Member Of

  NPD member
• Walgreen Co

  • Pharmacy
  • Menomonie, WI
  • NPI 1962417048

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232323200000",
    "number": "1790725588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3026 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740030",
            "telephone_number": "800-879-6137",
            "fax_number": "847-913-9024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 CLARK DR",
            "address_2": "UNITE 1-A",
            "city": "EAST BERLIN",
            "state": "CT",
            "postal_code": "060231157",
            "telephone_number": "800-755-1511",
            "fax_number": "860-828-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARTWELL SOUTHERN NEW ENGLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2009-01-19",
        "status": "A",
        "authorized_official_last_name": "BONACCORSI",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "847-229-7794",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "1385",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "CT",
            "license": "1385",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "1385",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "CT",
            "license": "1385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004129822",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004131132",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Option Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christina Marie Biondo
• Irene Bosco
• Kelly Ryan Bronk, LCSW
• Emily Bryant
• Joseph Cannata, RPH
• Kendell Lamonte Coker, PH.D., J.D.
• Concierge by NRC
• Counseling Center for Women and Children, LLC
• Anthony Cyrulik Jr., COTA
• Rebekka Kelly David

• All providers in East Berlin, CT
• Home Infusion Therapy Pharmacy in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2009; 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.