Active NPI
Kenneth Bisch, PHARM D
- Pharmacist
- Willimantic, CT
National Provider Identifier
1952073553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PCT.0015720
- Practice address
- 1475 Main St
Willimantic, CT 06226-1914 - Phone
- (860) 423-6304
- NPI assigned
- Oct 1, 2021
- Last updated
- Oct 1, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PCT.0015720 | CT | Primary |
Addresses
Primary practice location
1475 Main St
Willimantic, CT 06226-1914
Mailing address
907 Brookside CT Apt 907
Manchester, CT 06042-7117
Phone (203) 586-9905
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCT.0015720 | CT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Eastern Co Inc | Current | Accepting new patients | |
| Walgreen Eastern Co Inc | Past | Accepting new patients |
Locations
1475 Main St
Willimantic, CT 06226
Phone (860) 423-6304
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633046400000",
"number": "1952073553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "907 BROOKSIDE CT APT 907",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060427117",
"telephone_number": "203-586-9905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1475 MAIN ST",
"city": "WILLIMANTIC",
"state": "CT",
"postal_code": "062261914",
"telephone_number": "860-423-6304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BISCH",
"first_name": "KENNETH",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-01",
"last_updated": "2021-10-01",
"certification_date": "2021-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT.0015720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willimantic, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.