Organization
GPG LLC
Active
Other names
GREENWICH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DMITRI DANIAROV (MEMBER)
(800) 800-0000
Entity
Organization
Contact information
Practice address
118 MAIN ST, NEW CANAAN, CT 06840-4709
(203) 801-0808
(203) 801-0707
Mailing address
118 MAIN ST, NEW CANAAN, CT 06840-4709
(203) 801-0808
(203) 801-0707
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PCY.0002314
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2152977
PK
—
Enumeration date
06/29/2015
Last updated
05/13/2016
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