Organization
MCQUADES MARKETPLACE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE M WAY (MANAGER)
(401) 596-8843
Entity
Organization
Contact information
Practice address
14 CLARA DR, MYSTIC, CT 06355
(860) 536-3349
Mailing address
14 CLARA DR, MYSTIC, CT 06355
(860) 536-3349
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004140836
—
CT
Enumeration date
01/14/2020
Last updated
01/14/2020
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