Marilyn Christine O'Connor, RPH
Individual provider Active NPI Pharmacist · Uncaseville, CT
NPI 1982988713 · NPPES record last updated Sep 28, 2011
Key facts
- NPI
- 1982988713
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PCT.0010292 (CT)
- Practice address
- 1 Mohegan Sun Blvd
Walgreens
Uncaseville, CT 06382 - Phone
- (860) 859-9764
- NPI assigned
- Sep 28, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCT.0010292 | CT | MD | Pharmacist |
| PH23104 | MA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PCT.0010292 | CT | Yes |
| Pharmacist | 183500000X | PH23104 | MA |
Addresses
Primary practice location
1 Mohegan Sun Blvd
Walgreens
Uncaseville, CT 06382
Mailing address
271 Deerfield Ridge Drive
Mystic, CT 06355
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PCT.0010292 | Other | CT | RPH LICENSE |
| PH23104 | Other | MA | RPH LICENSE |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2011. 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.