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JEWETT CITY PHARMACY NPI 1689676074


NPI Information

NPI: 1689676074
Provider Name: JEWETT CITY PHARMACY

Doing Business As: JEWETT CITY PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 07D2116014

Address:
78 MAIN ST
JEWETT CITY, CT
ZIP 06351
Phone: (860) 376-4468
Get Directions

JEWETT CITY PHARMACY is a community/retail pharmacy pharmacy in Jewett City, CT. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. JEWETT CITY PHARMACY NPI is 1689676074. The provider is registered as an organization entity type.
The provider Is Doing Business As Jewett City Pharmacy.

The provider's business location address is:

78 MAIN ST
JEWETT CITY, CT
ZIP 06351-226
Phone: (860) 376-4468
Fax: (860) 376-0399

The provider's authorized official is Tony Komari .
The authorized official title is Owner/president/pic/ao and has the following contact phone number (860) 376-4468.

The CLIA number assigned to this NPI record is 07D2116014 - other - volunteer fire dept with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/15/2005 and was last updated on 7/19/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0004XPharmacyCompounding PharmacyNo
2332B00000XDurable Medical Equipment & Medical SuppliesNo
3333600000XPharmacyNo
43336C0003XPharmacyCommunity/Retail PharmacyPCY.0000657CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1004032751MEDICAIDCONNECTICUT
2004167971MEDICAIDCONNECTICUT
3004167963MEDICAIDCONNECTICUT
42001749OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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