Manchester Pharmacy,LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

1290 Issued in CT

Legal business name

MANCHESTER PHARMACY,LLC

Practice address

348 Main St
Manchester, CT 06040-4123

Phone

(860) 649-1025

Fax

(860) 649-0457

NPI assigned

Jun 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Anil K Puligilla, R.PH.

Title

Pharmacy Manager

Phone

(860) 649-1025

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Manchester Pharmacy Doing business as

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234915200000",
    "number": "1871538280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404123",
            "telephone_number": "860-649-1025",
            "fax_number": "860-649-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404123",
            "telephone_number": "860-649-1025",
            "fax_number": "860-649-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANCHESTER PHARMACY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2009-02-18",
        "status": "A",
        "authorized_official_last_name": "PULIGILLA",
        "authorized_official_first_name": "ANIL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "860-649-1025",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "1290",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CT",
            "license": "1290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008002078",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manchester Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Manchester Public Schools
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• Pharmacy in Manchester, CT
• Providers in Manchester, CT by specialty
• Pharmacy in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.