NPIMap

Organization Active NPI

Price Chopper Inc

  • Community/Retail Pharmacy
  • Windsor, CT
National Provider Identifier
1972708758
Registry record updated Jul 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PCY00002094 Issued in CT
Legal business name
PRICE CHOPPER INC
Practice address
675 Poquoncock Ave
Windsor, CT 06095
Phone
(860) 687-1910
Fax
(860) 687-9838
NPI assigned
Jun 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2015

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

Authorized official

Name
Kathleen Bryant
Title
VP of Pharmacy
Phone
(518) 379-1122

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PCY00002094 CT Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

675 Poquoncock Ave
Windsor, CT 06095

Mailing address

461 Nott St
MB#202
Schenectady, NY 12308-1812
Phone (518) 379-1618

Other identifiers 2

IdentifierTypeStateIssuer
2002828OtherPK
004270732MedicaidCT

Other names 1

  • PRICE CHOPPER PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080917000249 CT Part B Supplier - Mass Immunization (Roster Biller Only) 9335216340 9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bristol, CT; Middletown, CT; Oxford, CT; Putnam, CT; Torrington, CT; Windsor, CT
O20100930007795 CT DME Supplier - Pharmacy 9335216340 Practice locations: Windsor, CT

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Price Chopper Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Member of 3

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

Locations

675 Poquonock Ave
Windsor, CT 06095
Phone (860) 687-1910

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437696000000",
    "number": "1972708758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 NOTT ST",
            "address_2": "MB#202",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123081812",
            "telephone_number": "518-379-1618",
            "fax_number": "518-356-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 POQUONCOCK AVE",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "06095",
            "telephone_number": "860-687-1910",
            "fax_number": "860-687-9838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRICE CHOPPER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2015-07-24",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "VP OF PHARMACY",
        "authorized_official_telephone_number": "518-379-1122"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "PCY00002094",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2002828",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004270732",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRICE CHOPPER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Windsor, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.