Elizabeth Johnston
Individual provider Active NPI Pharmacist · Suffield, CT
NPI 1801344916 · NPPES record last updated Sep 18, 2016
Key facts
- NPI
- 1801344916
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0010125 (CT)
- Practice address
- 163 Mountain Rd
Suffield, CT 06078-2005 - Phone
- (860) 668-5115
- Fax
- (860) 668-0856
- NPI assigned
- Sep 18, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010125 | CT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connecticut CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Connecticut CVS Pharmacy LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0010125 | CT | Yes |
Addresses
Primary practice location
163 Mountain Rd
Suffield, CT 06078-2005
Mailing address
163 Mountain Rd
Suffield, CT 06078-2005
Phone (860) 668-5115
Other providers in Suffield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.