# MANCHESTER PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MANCHESTER PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861778581
- **Authorized official:** VIJAY VASIREDDY (PRESIDENT)
- **Authorized official phone:** (914) 318-0787

## Contact information

- **Practice address:** 348 MAIN ST, MANCHESTER, CT 06040-4123
- **Practice address phone:** (860) 649-1025
- **Practice address fax:** (860) 649-0457
- **Mailing address:** 348 MAIN ST, MANCHESTER, CT 06040-4123
- **Mailing address phone:** (860) 649-1025
- **Mailing address fax:** (860) 649-0457

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | PCY.0001290 | CT | Yes |

## Other

- **Enumeration date:** 10/26/2011
- **Last updated:** 10/26/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 008002078 | — | CT |
| 01 | — | 0722593 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |