# WOODMARK PHARMACY OF CT LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Woodmark Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194231571
- **Authorized official:** DR. JEFFREY RUBIN (CO-CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (716) 817-5075

## Contact information

- **Practice address:** 41 NORTHWEST DR, PLAINVILLE, CT 06062-1234
- **Practice address phone:** (860) 846-6369
- **Practice address fax:** (860) 996-2086
- **Mailing address:** 500 SENECA ST STE 100, BUFFALO, NY 14204-1963
- **Mailing address phone:** (716) 633-3900
- **Mailing address fax:** (860) 996-2086

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | PCY2366 | CT | Yes |

## Other

- **Enumeration date:** 12/20/2017
- **Last updated:** 09/13/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2176188 | PK | — |