Organization
ALBION - HANCOCK PHARMACY LLC
Active
Other names
ALBION - HANCOCK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RAJENDRA APPALANENI (OWNER)
(917) 568-9000
Entity
Organization
Contact information
Practice address
2125 FAIRFIELD AVE, BRIDGEPORT, CT 06605-2639
(203) 331-9200
(203) 331-9500
Mailing address
2125 FAIRFIELD AVE, BRIDGEPORT, CT 06605-2639
(203) 331-9200
(203) 331-9500
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PCY.0002332
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008064880
MEDICAID
CT
01
—
0724167
NCPDP
—
01
—
2158929
PK
—
01
—
PCY0002332
BOARD OF PHARMACY
CT
Enumeration date
01/16/2016
Last updated
03/07/2023
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