# PROCARE LTC PHARMACY OF CONNECTICUT LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Procare LTC Pharmacy of Connecticut LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174807002
- **Authorized official:** DR. BINCY VARGHESE PHARM D (DIRECTOR OF COMPLIANCE)
- **Authorized official phone:** (888) 741-0367

## Contact information

- **Practice address:** 1492 HIGHLAND AVE STE 1C, CHESHIRE, CT 06410-1287
- **Practice address phone:** (203) 439-9099
- **Practice address fax:** (631) 963-3990
- **Mailing address:** 1 OLYMPIC PL STE 600, TOWSON, MD 21204-4110
- **Mailing address phone:** (877) 741-0367

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 031744 | NY | — |
| 3336L0003X | Long Term Care Pharmacy | PCY0002214 | CT | Yes |
| 3336L0003X | Long Term Care Pharmacy | PHN11041 | RI | — |

## Other

- **Enumeration date:** 10/11/2011
- **Last updated:** 06/07/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 02869827 | — | CT |
| 01 | — | 2132865 | PK | — |