# BUNKER HILL PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BUNKER HILL PHARMACY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1154986867
- **Legal business name:** BUNKER HILL PHARMACY
- **Authorized official:** MR. CHRISTOPHER ROBERT OBRIEN PHARMD (MANAGER)
- **Authorized official phone:** (203) 574-7825

## Contact information

- **Practice address:** 256 BUNKER HILL AVE, WATERBURY, CT 06708
- **Practice address phone:** (203) 574-7825
- **Practice address fax:** (203) 574-4972
- **Mailing address:** 256 BUNKER HILL AVE, WATERBURY, CT 06708
- **Mailing address phone:** (203) 574-7825
- **Mailing address fax:** (203) 574-4972

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/08/2019
- **Last updated:** 05/08/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 004016036 | MEDICAID DMC | CT |
| 05 | — | 004027306 | — | CT |