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Organization
BUNKER HILL PHARMACY
Active
Organization
BUNKER HILL PHARMACY
Active
Parent organization
BUNKER HILL PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
BUNKER HILL PHARMACY
Authorized official
MR. CHRISTOPHER ROBERT OBRIEN PHARMD (MANAGER)
(203) 574-7825
Entity
Organization
Contact information
Practice address
256 BUNKER HILL AVE, WATERBURY, CT 06708
(203) 574-7825
(203) 574-4972
Mailing address
256 BUNKER HILL AVE, WATERBURY, CT 06708
(203) 574-7825
(203) 574-4972
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004016036
MEDICAID DMC
CT
05
—
004027306
—
CT
Enumeration date
05/08/2019
Last updated
05/08/2019
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