Organization
FREDERICK RAY PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL TAVARES PHARMD (PHARMACY MANAGER/OWNER)
(860) 367-4773
Entity
Organization
Contact information
Practice address
26 FALLS RD, MOODUS, CT 06469-1262
(860) 367-4773
Mailing address
PO BOX 457, MOODUS, CT 06469-0457
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
03/12/2020
Last updated
03/12/2020
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