Organization
COMPUTERX PHARMACY INC
Active
Organization
COMPUTERX PHARMACY INC
Active
Other names
ComputeRx Pharmacy IV
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL WILLIAM LICAMELE PHARM. D. (CHEIF EXECUTIVE OFFICER)
(203) 375-8000
Entity
Organization
Contact information
Practice address
35 ONTARIO ST, STRATFORD, CT 06615-7135
(203) 375-8000
(800) 784-5430
Mailing address
35 ONTARIO ST, STRATFORD, CT 06615-7135
(203) 375-8000
(800) 784-5430
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1524
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0076567170002
—
PA
05
—
0076567170003
—
PA
05
—
02620148
—
NY
05
—
2332587
—
OH
05
—
4645110
—
MI
05
—
7419007
—
NJ
05
—
7419015
—
NJ
05
—
81195000
—
WI
05
—
852021
—
AZ
05
—
9003226900
—
KY
05
—
9126431
—
VA
05
—
XDME03019
—
CA
Enumeration date
11/16/2005
Last updated
08/22/2020
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