Organization
MILE HILL PHARMACY LLC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL VETICA RPH (OWNER)
(860) 875-2507
Entity
Organization
Contact information
Practice address
79 EAST ST, ROCKVILLE, CT 06066-3845
(860) 875-2507
(860) 870-8160
Mailing address
79 EAST ST, ROCKVILLE, CT 06066-3845
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
0000793
CT
333600000X
Pharmacy
0793
CT
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004030383
—
CT
01
—
0706272
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/27/2006
Last updated
05/30/2013
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